lhamilton
Contributor
What modifiers do you use for in office iv sedation with medical claims?
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Wiki Oral surgery modifiers
- Thread starter lhamilton
- Start date
Michele Hannon
Guest
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?
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?
Last edited:
lhamilton
Contributor
I have used both but blue cross will not pay. Yes the oral surgeon is doing the sedation.
Michele Hannon
Guest
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.
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.