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When we bill 00170 with the modifier, they state the code is incidental to the procedure and we can't bill the patient. How do we deal with this? Also, is 00170 coded at the same number as D9223 or just once? Thank you in advance for your help!!!
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Hi Guest!
Yes is some cases the "D" code can be used, but if there is a direct CPT crosscode available is it best to use it.
For sedation, there are specific CPT codes available. If it is deep sedation:
00170 - Anesthesia for intraoral procedures, including biopsy; not otherwise specified
If it is moderate sedation:
99152 Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient’s level of consciousness and physiological status; initial 15 minutes of intraservice time, patient age 5 years or older
99153 Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient’s level of consciousness and physiological status; each additional 15 minutes intraservice time (list separately in addition to code for primary service)
99155 Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports; initial 15 minutes of intraservice time, patient younger than 5 years of age
99156 Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports; initial 15 minutes of intraservice time, patient age 5 years or older
99157 Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports; each additional 15 minutes intraservice time (list separately in addition to code for primary service)
Hope this helps!
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Can the D-codes be used in a Hospital facility. We have special needs patients that sedation is requested by the Dentist there, and wanted to make sure they were not just in office usable codes?
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Hi Guest,
In addition, if you are looking for someone to do your medical billing for your office, we do have MBS - a medical billing service here at Nierman Practice Management. If you'd like to provide me with your email, I'd be happy to email you information about that as well.
I hope this answers your question!
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Hi Guest!
We absolutely do offer CrossCoding Courses - Unlocking the Code to Medical Billing in Dentistry - all taught by our Founder and CEO Rose Nierman. We also offer DentalWriter Software for your office, to support your medical billing in your dental office. If you would like more information, dates and fees, as well as locations for our courses, all around the country, please provide me with your email or give us a call and we'd be happy to provide you with that information.
Thanks very much and we'd love to help you!
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Do you guys offers medical billing for the dental office and how it works(fees etc.)
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Thank you for the guidance.
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Hi Guest!
No problem:
D9222 – deep sedation/general anesthesia – first 15 minutes D9223 – deep sedation/general anesthesia – each additional 15 minutes can be crosscoded to: 00170 - Anesthesia for intraoral procedures, including biopsy; not otherwise specified
There is not a standard modifier I am aware of to use for the situation you're describing. If the insurer requires one, you may consider: QS - Monitored anesthesia care service
Hope this help!
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We need to submit the bill for the medical insurance,want to make sure the appropriate code for the D9222 and D9223. We have oral surgeon in the office and does all the impacted wisdom teeth removal surgeries under deep sedation.He does all this by himself so we don't have to take the help form the Anesthesiologist.I need help with the D9222 and d9223 and modifier code if it's needed.
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