# Oral surgery modifiers



## lhamilton (Mar 18, 2013)

What modifiers do you use for in office iv sedation with medical claims?


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## Michele Hannon (Mar 18, 2013)

Are you billing D codes?
D codes do not require a modifier.
D9241 IV sedation first 30 min
D9242 IV sedation additional 15 min
If you are not billing D codes.......wondering why not?
Who is providing the sedation?......the oral surgeon?


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## lhamilton (Mar 21, 2013)

I have used both but blue cross will not pay.  Yes the oral surgeon is doing the sedation.


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## Michele Hannon (Mar 21, 2013)

The patient probably does not have an oral surgery rider on their medical policy.

In my experience, the patient is seen and evaluated, a treatment plan is formulated (which includes the approximate cost), benefits are verified so the patient knows exactly what will/will not be covered.....often times the sedation is not covered.

If the oral surgeon is administering the sedation D codes should be used.

If the patient does indeed have an oral surgery rider on their medical insurance, you may need investigate those guidelines.


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