Can D9219 be used for pediatric patients?

Yes, D9219 can be used for pediatric patients when evaluating the need for sedation during dental treatments, especially in cases of high anxiety or complex procedures.

Is D9219 covered by insurance?

Coverage for D9219 varies by insurance provider. It's important to verify with the patient's insurance plan to understand the specific coverage and any limitations.

How should D9219 be documented?

Documentation should include a comprehensive assessment of the patient's medical history, sedation plan, consent forms, and any relevant notes on the sedation evaluation process.

Are there any modifiers associated with D9219?

Modifiers such as -47 may be applicable when the surgeon administers anesthesia. Always check the specific billing guidelines for the procedure.

D9219

Evaluation for Sedation - CDT Code Guide

Adjunctive General Services/Anesthesia

Overview

CDT Code D9219 pertains to the evaluation necessary for moderate sedation, deep sedation, or general anesthesia in dental procedures. This code is crucial for ensuring patient safety and appropriate sedation levels during complex dental treatments. Typically, this evaluation involves assessing the patient's medical history, current health status, and any potential risks associated with sedation. Dental professionals use this code when determining the most suitable anesthesia approach for procedures that may cause significant discomfort or anxiety. The evaluation is a critical step in planning for surgeries or extensive dental work, ensuring that the chosen sedation method aligns with the patient's needs and medical conditions.

When to Use This Code

When a patient requires sedation for a lengthy dental procedure
For patients with high anxiety or phobia towards dental treatments
Prior to oral surgery requiring deep sedation or general anesthesia
In cases where a patient has complex medical conditions affecting sedation
When evaluating the need for sedation in pediatric dental procedures

Documentation Requirements

Comprehensive patient medical history
Detailed sedation plan including type and dosage
Consent forms signed by the patient or guardian
Pre-sedation assessment notes
Post-procedure sedation monitoring records
Justification for the chosen level of sedation

Billing Considerations

When billing for D9219, ensure that the evaluation is documented separately from the procedure itself. Frequency limitations may apply depending on the insurance provider, and it's important to verify coverage for sedation evaluations. Common modifiers such as -47 (Anesthesia by Surgeon) may be applicable. Always check with the patient's insurance for specific guidelines on sedation coverage.

Related CDT Codes

D9222 D9223 D9230 D9248

Frequently Asked Questions

The D9219 code is used for evaluating a patient's suitability for moderate to deep sedation or general anesthesia, ensuring safety and effectiveness during dental procedures.

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