Read American Association of Oral and Maxillofacial Surgeons text version

American Association of Oral and Maxillofacial Surgeons Coding for Dentoalveolar Surgery

2010

I.

INTRODUCTION

This AAOMS coding paper is designed to provide information on coding claims for oral and maxillofacial surgery (OMS) and deals exclusively with dentoalveolar surgery. Without question dentoalveolar surgery still accounts for the majority of OMS procedures performed today. Recent coding changes and the dynamically changing health care delivery system demand concise and accurate coding to ensure fair and reasonable reimbursement from third parties. As managed care networks gain greater acceptance and market penetration, use of medical ICD-9-CM and CPT coding will become increasingly important in this traditionally "dental" area. The following outline is presented to assist in appropriate coding for dentoalveolar surgical procedures. REQUIRED CODING MATERIALS Before attempting to code any claims for services, it is necessary to have a current copy of the American Medical Association CPT (Current Procedural Terminology), the two-volume set of ICD-9-CM and the American Dental Association CDT 2009/2010 (Current Dental Terminology). Volumes 1 and 2 of the ICD-9-CM cover diagnostic coding which is mandatory in filing claims with Medicare and other medical third party payers. Volume 1 represents a tabular listing of conditions, diseases, and symptoms; while volume 2 is the alphabetical listing. Volume 3 of the ICD-9-CM is only for hospitals, and is not necessary for the OMS office. CPT and ICD-9-CM are both revised annually. CDT is revised every 2 years, the most recent edition being 2009/2010, and the next edition planned for 2011. The new edition of CPT becomes available in mid-November for the following year. Annual code changes to ICD-9-CM are implemented by the government. They are effective October 1 and April 1, and valid through the following September 30th. Many changes and additions are made to CPT and ICD9-CM each year. Thus, reporting a current procedure or diagnosis using a previous year's edition may be inaccurate and adversely affect reimbursement. II. ICD-9-CM DIAGNOSIS CODES

Available ICD-9-CM diagnosis codes which may be appropriate for use in dentoalveolar surgical cases are as follows:

1

520 Disorders of tooth development and eruption 520.0 Anodontia Absence of teeth(complete)(congenital)(partial) Hypodontia Oligodontia

Excludes: acquired absence of teeth(525.10-525.19) 520.1 Supernumerary teeth Distomolar Fourth molar Mesiodens Paramolar Supplemental Teeth

Excludes: supernumerary roots ( 520.1) 520.2 Abnormalities of size and form (i.e., fusion, germination) Concrescence Fusion of teeth Gemination Dens evaginatus Dens in dente Dens invaginatus Enamel pearls Macrodontia Microdontia Peg-shaped (conical) teeth Supernumerary roots Taurondontism Tuberculum paramolare Excludes: that due to congenital syphilis(090.5) Tuberculum Carabelli, which is regarded as a normal variation 520.3 Mottled teeth Mottling of enamel Dental fluorosis Nonflouride opacities

2

520.4

Disturbances of tooth formation (i.e. enamel hypoplasia) Aplasia and hypoplasia of cementum Dilaceration of tooth Enamel hypoplasia (neonatal) (postnatal)(prenatal) Horner's teeth Hypocalcification of teeth Regional odontodyspasia Turner's tooth Excludes: Hutchinson's teeth and mulberry molars in congenital syphilis (090.5) mottled teeth ( 520.3)

520.5

Hereditary disturbances in tooth structure, not elsewhere classified Amelogenesis Dentinogenesis imperfecta Odontogenesis Dentinal dysplasia Shell teeth

520.6 Disturbances in tooth eruption Teeth: embedded impacted natal neonatal prenatal primary(deciduous): persistent shedding, premature Tooth eruption: late obstructed premature Excludes: exfoliation of teeth (attributable to the disease of surrounding tissues) (525.0-525.19) 520.7 Teething syndrome 520.8 Other specified disorders of tooth development and eruption Color changes during tooth formation Pre-eruptive color changes

3

Excludes: posteruptive color changes (521.7) 520.9 Unspecified disorder of tooth development and eruption 521 Diseases of hard tissues of teeth 521.0 Dental caries 521.00 521.01 Dental caries, unspecified Dental caries, limited to the enamel Initial caries White spot lesion Dental caries, extending into dentine Dental caries, extending into pulp Arrested dental caries Odontoclasia Infantile melanodontia Melanodontoclasia

521.02 521.03 521.04 521.05

Excludes: internal and external resorption of teeth (521.40521.49) 521.06 Dental caries pit and fissure Primary dental caries, pit and fissure origin Dental caries of smooth surface Primary dental caries, smooth surface origin Dental caries of root surface Primary, dental caries, root surface Other dental caries

521.07

521.08

521.09

521.1 Excessive attrition (approximal wear) (occlusal wear) 521.10 Excessive attrition, unspecified

4

521.11 521.12 521.13 521.14 521.15 521.2

Excessive attrition, limited to enamel Excessive attrition, extending into dentine Excessive attrition, extending into pulp Excessive attrition, localized Excessive attrition, generalized Abrasion Abrasion: dentifrice habitual occupational ritual traditional Wedge defect NOS Abrasion, unspecified Abrasion, limited to enamel Abrasion, extending into dentine Abrasion, extending into pulp Abrasion, localized Abrasion, generalized

521.20 521.21 521.22 521.23 521.24 521.25 521.3 Erosion

Erosion of teeth NOS due to: medicine persistent vomiting idiopathic occupational 521.30 521.31 Erosion, unspecified Erosion, limited to enamel

5

521.32 521.33 521.34 524.35 521.4

Erosion, extending into dentine Erosion, extending into pulp Erosion, localized Erosion, generalized

Pathological resorption 521.40 521.41 521.42 521.49 Pathological resorption, unspecified Pathological resorption, internal Pathological resorption, external Other pathological resorption Internal granuloma of pulp

521.5 Hypercementosis Cementation hyperplasia 521.6 Ankylosis of teeth

521.7 Intrinsic posteruptive color changes Staining (discoloration) of teeth: NOS due to: drugs metals pulpal bleeding Excludes: accretions (deposits) on teeth (523.6) extrinsic color changes (523.6) pre-eruptive color changes (520.8) 521.8 Other specified diseases of hard tissues of teeth 521.81 Cracked tooth Excludes: asymptomatic craze lines in enamel-omit code broken tooth due to trauma(873.63, 873.73) fractured tooth due to trauma (873.63, 873.73)

6

521.89 Other specified diseases of hard tissues of teeth Irradiated enamel Sensitive dentin 521.9 Unspecified disease of hard tissues of teeth 522 522.0 Diseases of pulp and periapical tissues Pulpitis Pulpal abscess polyp Pulpitis acute chronic(hyperplastic)(ulcerative) suppurative Necrosis of pulp Pulp gangrene

522.1

522.2 Pulp degeneration Denticles Pulp calcifications Pulp stones 522.3 Abnormal hard tissue formation in pulp Secondary or irregular dentin 522.4 522.5 Acute apical periodontitis of pulpal origin Periapical abscess without sinus Abscess: dental dentoalveolar periapical abscess with sinus (522.7) 522.6 Chronic apical periodontitis Apical or periapical granuloma Apical periodontitis NOS Periapical abscess with sinus Fistula:

Excludes:

522.7

7

alveolar process dental 522.8 Radicular cyst

Cyst: apical (periodontal) periapical radiculodental residual radicular

Excludes:

lateral developmental or lateral periodontal cyst (526.0)

522.9 Other and unspecified diseases of pulp and periapical tissues 523 Gingival and periodontal diseases 523.0 Acute gingivitis

Excludes: acute necrotizing ulcerative gingivitis (101) herpetic gingivostomatitis (054.2) 523.00 Acute Gingivitis, plaque induced Acute gingivitis NOS Acute Gingivitis, non-plaque induced

523.01 523.1

Chronic gingivitis Gingivitis(chronic): desquamative hyperplastic simple marginal ulcerative Excludes: herpetic gingivostomatitis (054.2) 523.10 Chronic gingivitis, plaque induced Chronic gingivitis NOS Gingivitis NOS Chronic gingivitis, non-plaque induced

523.11 523.2

Gingival recession

8

Gingival recession(postinfective) (postoperative) 523.20 523.21 523.22 523.23 523.24 523.25 523.3 Gingival recession, unspecified Gingival recession, minimal Gingival recession, moderate Gingival recession, severe Gingival recession, localized Gingival recession, generalized

Aggressive and acute periodontitis Acute: pericementitis pericoronitis

Excludes: acute apical periodontitis (522.4) periapical abscess (522.5, 522.7) 523.30 523.31 Aggressive periodontitis, unspecified Aggressive periodontitis, localized periodontal abscess Aggressive periodontitis, generalized Aggressive periodontitis

523.32 523.33 523.4

Chronic periodontitis Chronic pericoronitis Pericementitis (chronic) Periodontitis: NOS complex simplex Excludes: chronic apical periodontitis (522.6) 523.40 Chronic periodontitis, unspecified

9

523.41 523.42 523.5 523.6

Chronic periodontitis, localized Chronic periodontitis, generalized

Periodontosis

Accretions on teeth Dental calculus: subgingival supragingival Deposits on teeth: betel materia alba soft tartar tobacco Extrinsic discoloration of teeth Excludes: intrinsic discoloration of teeth (521.7) Other specified periodontal diseases Giant cell: epulis peripheral granuloma Gingival: cysts enlargement NOS fibromatosis Gingival polyp Periodontal lesions due to traumatic occlusions Peripheral giant cell granuloma

523.8

Excludes: leukoplakia of gingiva (528.6) 523.9 Unspecified gingival and periodontal disease

524 Dentofacial Anomalies, including malocclusion 524.3 Anomalies of tooth position of fully erupted teeth

Excludes: Impacted or embedded teeth with abnormal position of such teeth or adjacent

10

teeth (520.6) 524.30 Unspecified anomaly of tooth position Diastema of teeth NOS Displacement of teeth NOS Transposition of teeth NOS Crowding of teeth Excessive spacing of teeth Horizontal displacement of teeth Tipped teeth Tipping of teeth Vertical displacement of teeth Extruded tooth Infraeruption of teeth Intruded tooth Supraeruption of teeth Rotation of tooth/teeth Insufficient interocclusal distance of teeth (ridge) Lack of adequate intermaxillary vertical dimension Excessive interocclusal distance of teeth Excessive intermaxillary vertical dimension Loss of occlusal vertical dimension Other anomalies of tooth position

524.31 524.32 524.33

524.34

524.35 524.36

524.37

524.39

525 Other diseases and conditions of the teeth and supporting structures 525.0 525.1 Exfoliation of teeth due to systemic causes Loss of teeth due to trauma, extraction or periodontal disease 525.10 525.11 525.12 Acquired absence of teeth, unspecified Loss of teeth due to trauma Loss of teeth due to periodontal disease

11

525.13 525.19 525.2

Loss of teeth due to caries Other loss of teeth

Atrophy of edentulous alveolar ridge 525.20 Unspecified atrophy of edentulous alveolar ridge Atrophy of the mandible NOS Atrophy of the maxilla NOS Minimal atrophy of the mandible Moderate atrophy of the mandible Severe atrophy of the mandible Minimal atrophy of the maxilla Moderate atrophy of the maxilla Severe atrophy of the maxilla

525.21 525.22 525.23 525.24 525.25 525.26 525.3

Retained dental root

525.4 Complete edentulism 525.40 Complete edentulism, unspecified Edentulism NOS 525.41 Complete edentulism, class I 525.42 Complete edentulism, class II 525.43 Complete edentulism, class III 525.44 Complete edentulism, class IV 525.5 Partial edentulism 525.50 Partial edentulism, unspecified 525.51 Partial edentulism, class I 525.52 Partial edentulism, class II 525.53 Partial edentulism, class III 525.54 Partial edentulism, class IV Unsatisfactory restoration of tooth Defective bridge, crown, fillings Defective dental restoration

525.6

12

Excludes: dental restoration status (V45.84) unsatisfactory endodontic treatment ( 526.61-526.69) 525.60 Unspecified unsatisfactory restoration of tooth Unspecified defective dental restoration 525.61 Open restoration margins Dental restoration failure of marginal integrity Open margin on tooth restoration Unrepairable overhanging of dental restorative materials Overhanging of tooth restoration

525.62

525.63 Fractured dental restorative material without loss of material Excludes: cracked tooth (521.81) fractured tooth( 873.63, 873.73) 525.64 Contour of existing restoration of tooth biologically incompatible with oral health Dental restoration failure of periodontal anatomical integrity Unacceptable contours of existing restoration Unacceptable morphology of existing restoration Allergy to existing dental restorative material Poor aesthetics of existing restoration Dental restoration aesthetically inadequate or displeasing Other unsatisfactory restoration of existing tooth Other specified disorders of the teeth and supporting structures Enlargement of alveolar ridge NOS Irregular alveolar process Unspecified disorder of the teeth and supporting structures

525.66 525.67

525.69 525.8

525.9

526 Diseases of Jaw

526.0 Developmental Odontogenic Cysts Cyst: dentigerous 13

eruption follicular lateral developmental lateral periodontal primordial Keratocyst

Excludes:

radicular cyst (522.8) 526.1 Fissural Cysts of Jaw Cyst: globulomaxillary incisor canal median anterior maxillary median palatine nasopalatine palatine of papilla

Excludes:

cysts of oral soft tissues (528.4) 526.2 Other cyst of jaws Cyst of jaw NOS aneurysmal hemorrhagic traumatic

526.3 Central giant cell (reparative) granuloma

Excludes: peripheral giant cell granuloma (523.8) 526.4 Inflammatory conditions Abscess Osteitis Osteomyelitis Periostitis Sequestrum of jaw bone Alveolitis of jaw Alveolar Osteitis Dry Socket

of jaw (acute) (chronic) (supporative)

526.5

14

526.6

Periradicular pathology associated with previous endodontic treatment 526.61 Perforation of root canal space 526.62 Endodontic overfill 526.63 Endodontic underfill 526.69 Other periradicular pathology associated with previous endodontic treatment Other specified diseases of the jaws Exostosis of Jaw Torus mandibularis Torus palatinus Other Cherubism Fibrous dysplasia of jaws Latent bone cyst Osteoradionecrosis Unilateral condylar hyperplasia or hypoplasia of mandible Unspecified diseases of the jaw

526.8 526.81

526.89

526.9 528

Diseases of the oral soft tissues, excluding lesions specific for gingiva and tongue 528.0 Stomatitis and mucositis (ulcerative)

Excludes: cellulitis in abscess of mouth (528.3) diphtheritic stomatitis (032.0) epizootic stomatitis (078.4) gingivitis(523.0-523.1) oral thrush(112.0) Stevens- Johnson syndrome (695.13) stomatitis: acute necrotizing ulcerative(101) apthous (528.1) gangrenous (528.1) herpetic (054.2) Vincent's (101) 528.00 Stomatitis and mucositis, unspecified Mucositis NOS

15

Ulcerative mucositis NOS Ulcerative stomatitis NOS Vesicular stomatitis NOS 528.01 528.02 528.09 528.1 Mucocitis (ulcerative) due to antineoplastic therapy Mucositis (ulcerative) due to other drugs Other stomatitis and mucositis (ulcerative)

Cancrum oris Gangrenous stomatitis Noma

528.2

Oral aphthae Aphthous stomatitis Canker sore Periadenitis mucosa necrotica recurrens Recurrent aphthous ulcer Stomatitis herpetiformis Excludes: herpetic stomatitis (054.2) Cellulitis and abscess Cellulitis of mouth (floor) Ludwig's angina Oral fistula Excludes: abscess of tongue (529.0) cellulitis or abscess of lip(528.5) fistula (of): dental(522.7) lip(528.5) gingivitis (523.00- 523.11)

528.3

MISCELLANEOUS 750.0 Tongue Tie Ankyloglossia Headache Facial/head pain

784.0

16

873.63 Excludes:

Tooth (broken), (fractured) (due to trauma) cracked tooth(521.81)

873.73

Tooth (broken), (fractured) (due to trauma)

Excludes: cracked tooth(521.81)

990

Effects of radiation, unspecified

Note: Appropriate and correct diagnostic coding require use of both the index describing a condition and the tabular list for confirmation of the specific condition.

III.

CPT PROCEDURE CODING

The CPT procedural codes have rather limited application for routine dentoalveolar procedures as indicated below. 21031 21032 40800 40801 40804 40805 40806 40819 40840 40842 40843 Excision of torus mandibularis Excision of maxillary torus palatinus Drainage of abscess, cyst, hematoma, vestibule of mouth; simple complicated Removal of embedded foreign body, vestibule of mouth; simple complicated Incision of labial frenum (frenotomy) Excision of frenum, labial or buccal (frenumectomy, frenulectomy, frenectomy) Vestibuloplasty; anterior posterior, unilateral posterior, bilateral

17

40844 40845 40899 41000

entire arch complex (including ridge extension, muscle repositioning) Unlisted procedure, vestibule of mouth Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; lingual sublingual, superficial sublingual, deep, supramylohyoid submental space submandibular space masticator space Incision of lingual frenum (frenotomy) Extraoral incision and drainage of abscess, cyst or hematoma of floor of mouth; sublingual submental submandibular masticator space Excision of lingual frenum (frenectomy) Frenoplasty (surgical revision of frenum, eg. with Z-plasty) Drainage of abscess, cyst, hematoma from dentoalveolar structures Removal of embedded foreign body from dentoalveolar structures: soft tissues bone Gingivectomy, excision gingiva, each quadrant

41005 41006 41007 41008 41009 41010 41015

41016 41017 41018 41115 41520 41800 41805 41806 41820

18

41821 41822 41823 41825

Operculectomy, excision pericoronal tissues Excision of fibrous tuberosities, dentoalveolar structures Excision of osseous tuberosities, dentoalveolar structures Excision of lesion or tumor (except listed above), dentoalveolar structures; without repair with simple repair with complex repair Excision of hyperplastic alveolar mucosa, each quadrant (specify) Alveolectomy, including curettage of osteitis or sequestrectomy Destruction of lesion (except excision), dentoalveolar structures Periodontal mucosal grafting Gingivoplasty, each quadrant (specify) Alveoloplasty, each quadrant (specify) Unlisted procedure, dentoalveolar structures (removal of teeth)

41826 41827 41828 41830 41850 41870 41872 41874 41899

Most of the dentoalveolar CPT codes are considered CCI comprehensive codes. This means that all associated parts of the procedure are all inclusive and should not be billed separately. For example, local anesthesia is inclusive of the procedure. IV. CDT 2009/2010 DENTAL PROCEDURAL CODES

Practically all significant dentoalveolar surgical procedures and associated office encounters can be identified in the current CDT 2009/2010. The following codes are new or revised for the CDT 2009/2010. D4000-4999 V. PERIODONTICS Surgical Services (Including Usual Postoperative Care) D4210 gingivectomy or gingivoplasty- four or more contiguous teeth or tooth bounded spaces per quadrant

19

Involves the excision of the soft tissue wall of the periodontal pocket by either an external or internal bevel. It is performed to eliminate suprabony pockets after adequate initial preparation, to allow access for restorative dentistry in the presence of suprabony pockets, or to restore normal architecture when gingival enlargements or asymmetrical or unaesthetic topography is evident with normal bone configuration. D4211 gingivectomy or gingivoplasty- one or three contiguous teeth or tooth bounded spaces per quadrant Involves the excision of the soft tissue wall of the periodontal pocket by either an external or internal bevel. It is performed to eliminate suprabony pockets after adequate initial preparation, to allow access for restorative dentistry in the presence of suprabony pockets, or to restore normal architecture when gingival enlargements or asymmetrical or unaesthetic topography is evident with normal bone configuration. D4240 gingival flap procedure, including root planing- four or more contiguous teeth contiguous teeth or tooth bounded spaces per quadrant A soft tissue flap is reflected or resected to allow débridement of the root surface and the removal of granulation tissue. Osseous recontouring is not accomplished in conjunction with this procedure. May include open flap curettage, reverse bevel flap surgery, modified Kirkland flap procedure, and modified Widman surgery. This procedure is performed in the presence of moderate to deep probing depths, a loss of attachment, need to maintain aesthetics, need for increased access to the root surface and alveolar bone, or to determine the presence of a cracked tooth, fractured root, or external root resorption. Other procedures may be required concurrent to D42141 and should be reported separately using their own unique codes.

D4241 gingival flap procedure, including root planing- one to three contiguous teeth or tooth bounded spaces per quadrant A soft tissue flap is reflected or resected to allow débridement of the root surface and the removal of granulation tissue. Osseous recontouring is not accomplished in conjunction with this procedure. May include open flap curettage, reverse bevel flap surgery, modified Kirkland flap procedure, and modified Widman surgery. This procedure is performed in the presence of moderate to deep probing depths, a loss of attachment, need to maintain aesthetics, need for increased access to the root surface and alveolar bone, or to determine the presence of a cracked tooth, fractured root, or external root resorption. Other procedures may be required concurrent to D42141 and should be reported separately using their own unique codes.

20

D4260

osseous surgery ( including flap entry and closure)- four or more contiguous teeth or tooth bounded spaces per quadrant This procedure modifies the bone support of the cheap by reshaping the alveolar process to achieve a more physiologic form. This may include the removal of supporting bone (ostectomy) and/or non-supporting bone (osteoplasty). Other procedures may be required concurrent to D4261 and should be reported using their own unique codes.

D4261 osseous surgery ( including flap entry and closure)- one to three contiguous teeth or tooth bounded spaces per quadrant This procedure modifies the bone support of the cheap by reshaping the alveolar process to achieve a more physiologic form. This may include the removal of supporting bone (ostectomy) and/or non-supporting bone (osteoplasty). Other procedures may be required concurrent to D4261 and should be reported using their own unique codes.

D7000-D7999 X. ORAL and MAXILLOFACIAL SURGERY Alveoloplasty ­ Surgical Preparation of Ridge for Dentures

D7310 alveoloplasty in conjunction with extractions - four or more teeth or tooth spaces, per quadrant The alveoloplasty is distinct (separate procedure) from extractions and/or surgical extractions. Usually in preparation for a prosthesis or other treatments such as radiation therapy and transplant surgery. D7311 alveoloplasty in conjunction with extractions ­ one to two teeth or tooth spaces, per quadrant The alveoloplasty is distinct (separate procedure) from extractions and/or surgical extractions. Usually in preparation for a prosthesis or other treatments such as radiation therapy and transplant surgery.

D7320 alveoloplasty not in conjunction with extractions - four or more teeth or tooth spaces, per quadrant No extractions performed in an edentulous area. See D7310 if teeth are being extracted concurrently with the alveoloplasty. Usually in preparation for a prosthesis or other treatments such as radiation therapy and transplant surgery. D7321 alveoloplasty not in conjunction with extractions - four or more teeth or tooth spaces, per quadrant

21

No extractions performed in an edentulous area. See D7310 if teeth are being extracted concurrently with the alveoloplasty. Usually in preparation for a prosthesis or other treatments such as radiation therapy and transplant surgery.

D9000-D9999 XII ADJUNCTIVE GENERAL SERVICES Anesthesia D9220 deep sedation/general anesthesia- first 30 minutes Anesthesia time begins when a doctor administrating the anesthetic agent initiates the appropriate anesthesia and non-invasive monitoring protocol and remains a continuous attendance of the patient. Anesthesia services are considered completed when the patient may be safely left under the observation of trained personnel and the doctor may safely leave the room to attend to other patients our duties. The level of anesthesia is determined by the anesthesia provider's documentation of the anesthetic's effects upon the central nervous system and not dependent upon the route of administration. D9221 deep sedation/general anesthesia- each additional 15 minutes Anesthesia time begins when a doctor administrating the anesthetic agent initiates the appropriate anesthesia and non-invasive monitoring protocol and remains a continuous attendance of the patient. Anesthesia services are considered completed when the patient may be safely left under the observation of trained personnel and the doctor may safely leave the room to attend to other patients our duties. The level of anesthesia is determined by the anesthesia provider's documentation of the anesthetic's effects upon the central nervous system and not dependent upon the route of administration. D9241 intravenous conscious sedation/analgesia- first 30 minutes Anesthesia time begins when a doctor administrating the anesthetic agent initiates the appropriate anesthesia and non-invasive monitoring protocol and remains a continuous attendance of the patient. Anesthesia services are considered completed when the patient may be safely left under the observation of trained personnel and the doctor may safely leave the room to attend to other patients our duties. The level of anesthesia is determined by the anesthesia provider's documentation of the anesthetic's effects upon the central nervous system

22

and not dependent upon the route of administration. D9242 intravenous conscious sedation/analgesia- each additional 15 minutes Anesthesia time begins when a doctor administrating the anesthetic agent initiates the appropriate anesthesia and non-invasive monitoring protocol and remains a continuous attendance of the patient. Anesthesia services are considered completed when the patient may be safely left under the observation of trained personnel and the doctor may safely leave the room to attend to other patients our duties. The level of anesthesia is determined by the anesthesia provider's documentation of the anesthetic's effects upon the central nervous system and not dependent upon the route of administration. D9248 non-intravenous conscious sedation A medically controlled state of depressed consciousness while maintaining the patient's airway, protective reflexes and the ability to respond to stimulation or verbal commands. It includes non-intravenous administration of sedative and/or analgesic agent(s) and appropriate monitoring. The level of anesthesia is determined by the anesthesia provider's documentation of the anesthetic's effects upon the central nervous system and not dependent upon the route of administration.

Note: This paper should not be utilized as the sole reference in coding. Both diagnosis and treatment codes change frequently, and insurance carriers may differ in their interpretations of the codes.

2010 American Association of Oral and Maxillofacial Surgeons 9700 West Bryn Mawr Avenue Rosemont, Illinois 60018-5701 No portion of this publication may be used or reproduced without the express written consent of the American Association of Oral and Maxillofacial Surgeons. Revised March 2010

23

Information

American Association of Oral and Maxillofacial Surgeons

23 pages

Find more like this

Report File (DMCA)

Our content is added by our users. We aim to remove reported files within 1 working day. Please use this link to notify us:

Report this file as copyright or inappropriate

3863


You might also be interested in

BETA
American Association of Oral and Maxillofacial Surgeons