Anesthesia Coding Alert

Question: How should I code for IV sedation during wisdom-teeth removal? Is this separately billable, or is it considered part of the procedure?

Pennsylvania Subscriber

Answer: Coding for IV sedation in this situation depends on whether the physician or dentist performs it, because most states have separate codes for dental billing. If the physician performing the IV sedation is a medical doctor, he or she can bill the appropriate code for tooth removal along with modifier -47 (Anesthesia by surgeon) or with the conscious sedation codes if appropriate (99141, Sedation with or without analgesia [conscious sedation]; intravenous, intramuscular or inhalation; or 99142, oral, rectal and/or intranasal).

If a physician other than the surgeon performs the IV sedation, code with 00170 (Anesthesia for intraoral procedures, including biopsy; not otherwise specified) along with the applicable physical status modifier for the patient and modifier -52 (Reduced services). IV sedation is less involved than general anesthesia, which is why you use modifier -52 in this type of situation.