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Dental Anesthesia Coding and Usage of CDT Codes

by Outsource Strategies International Medical Billing Company
To report dental claims, you should only use Current Dental Terminology (CDT) codes and not CPT (Current Procedure Terminology) codes. CDT codes provide uniformity, consistency and specificity in reporting and documenting dental treatments accurately and thereby facilitate efficient processing of dental claims. There are some differences in anesthesiology medical billing using CDT codes as compared to CPT (medical) based billing:

  • Under CDT coding, the ‘Time Unit’ (the time taken to provide anesthesia services) concept and ‘Modifiers’ (special conditions that affect anesthesia) are absent

  • CDT codes do not differentiate between operator administered anesthesia and anesthesia provided by another practitioner

The concepts of materials, supplies and facility are also basically different in dental and medical billing and these differences must be taken into account while coding. However, the use of local anesthesia is considered as an inherent component of any surgical procedure under both CDT and CPT and is therefore not billable separately.

CDT codes for Dental Anesthesia

While you are submitting bills for anesthesia services to a dental insurance company, you should use the following CDT codes:

  • D9220: deep sedation/general anesthesia - first 30 minutes

  • D9221: deep sedation/general anesthesia - each additional 15 minutes

  • D9230: analgesia, anxiolysis, inhalation of nitrous oxide

  • D9241: intravenous conscious sedation/analgesia – first 30 minutes

  • D9242: intravenous conscious sedation/analgesia – each additional 15 minutes

  • D9248: non-intravenous conscious sedation

The additional CDT anesthesia codes used for anesthesiology medical coding, but that are not applicable to anesthesia utilized in conjunction with a procedure are

  • D9210: local anesthesia not in conjunction with operative or surgical procedures

  • D9211: regional block anesthesia

  • D9212: trigeminal division block anesthesia

  • D9215: local anesthesia in conjunction with operative or surgical procedures


Definition of Start/Stop Time

It is very important to report the exact number of anesthesia code units (one unit may be equal to 15 minutes) during documentation as this is necessary to select the appropriate codes. For example, dental codes D9220 (deep sedation/general anesthesia - first 30 minutes) and D9241 (intravenous conscious sedation/analgesia – first 30 minutes) describe 15 additional minutes of monitored anesthesia. Reporting the exact number of anesthesia code units is possible only if you keep track of and note the anesthesia start and stop time.

Anesthesia time starts when the anesthesia provider initiates the anesthesia protocol and remains in continuous attendance of the patient and ends when the provider can leave the patient under postoperative supervision of a trained anesthesia assistant.

Using CDT codes for Medical Claims

Generally, CPT codes are not used on American Dental Association (ADA) forms and CDT codes are not used on Centers for Medicare and Medicaid Services (CMS) 1500 forms. Even so, certain carriers may insist that CDT codes are used on a CMS 1500 form for ‘dental’ procedures that do not have an applicable CPT code. In such cases, they may require use of CDT anesthesia codes.

The payment for dental anesthesia services is not guaranteed with only an anesthesia dental code. It is crucial to know the reimbursement model for anesthesia services of each insurance carrier, managed care organization and Medicare for accurate dental anesthesia coding.


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About Outsource Strategies International Senior   Medical Billing Company

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Created on Dec 31st 1969 18:00. Viewed 0 times.

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