Dental anesthesia sedation can be reported with procedure codes D9230 and D9248. Below the descriptions and billing guidelines.
D9230 | Nitrous Oxide
D9230 is defined as: “inhalation of nitrous oxide/analgesia, anxiolysis.”
The D9230 dental code can only be used for providers that have a permit do the administration of nitrous oxide inhalation analgesia. This permit is issued by the Louisiana State Board of Dentistry and the service is performed in a state board approved facility.
Reimbursement is only possible for the dates of service on which the surgical services or restorative services are performed.
Bill nitrous oxide on the same claim for as the surgical services and or restorative services.
Reimbursement for nitrous oxide will be denied if there are no surgical services or restorative services on the claim form. Payment for nitrous oxide won’t be reimbursed if the history record of a Medicaid claim indicates that the service was already reimbursed for the same date of service as the nitrous oxide.
D9230 is only payable for individuals younger than 21. This dental code is payable in combination with dental treatment of physically, mentally or medically compromised individuals whose maturity limits the ability to undergo dental treatment.
Payment for dental code D9230 precludes payment for other remaining codes on the same date of service.
Dental code D9230 won’t be reimbursed if billed in combination with D9248.
D9248 | Non-Intravenous Conscious Sedation
The D9248 dental code is defined as: “non-intravenous conscious sedation.”
This procedure code will only be reimbursed for children with behavioural problems of 6 years of age or younger. The D9248 dental code will also be paid for are mentally or physically handicapped.
D9248 won’t be reimbursed for non-intravenous conscious sedation on the same day and provided by the same provider as procedure code D9230 and D9920.
Payment for dental code D9248 precludes payment for other remaining codes on the same date of service.
Copay Changes For Sedation Services Copayments
The following procedure codes are no longer applied to any covered dental sedation services or anesthesia services:
- D9223: Deep sedation/general anesthesia. Billed per fifteen minute increment.
- D9230: Inhalation of nitrous oxide/analgesia, anxiolysis.
- D9243: intravenous moderate (conscious) sedation/analgesia. Billed each subsequent fifteen minute increment.
- D9248: Non-intravenous conscious sedation.
Claims with a copayment for DOS will have to be adjusted for appropriate provider reimbursement.