Our client owns a pediatric dental clinic. The code that my client uses on a maximum basis is 9248 in conjunction with 9230. The total UCR for these is 295 and 55 respectively. They are mostly used together. So this puts my client in a situation that if they are covered, then he gets paid less, because usually the parent would pay out of pocket for these, and the whole procedure would make sense. Now with such a low fee, it does not make sense considering the stress involved. Is there any alternative way/ code(s) to charge for non-intravenous sedation using inhalation of Nitrous Oxide. Is there any scope of charging, using ASA (CPT) codes if the patient also has medical insurance coverage apart from dental coverage?

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  • Our client owns a pediatric dental clinic. The code that my client uses on a maximum basis is 9248 in conjunction with 9230. The total UCR for these is 295 and 55 respectively. They are mostly used together. So this puts my client in a situation that if they are covered, then he gets paid less, because usually the parent would pay out of pocket for these, and the whole procedure would make sense. Now with such a low fee, it does not make sense considering the stress involved. Is there any alternative way/ code(s) to charge for non-intravenous sedation using inhalation of Nitrous Oxide. Is there any scope of charging, using ASA (CPT) codes if the patient also has medical insurance coverage apart from dental coverage?

Our client owns a pediatric dental clinic. The code that my client uses on a maximum basis is 9248 in conjunction with 9230. The total UCR for these is 295 and 55 respectively. They are mostly used together. So this puts my client in a situation that if they are covered, then he gets paid less, because usually the parent would pay out of pocket for these, and the whole procedure would make sense. Now with such a low fee, it does not make sense considering the stress involved. Is there any alternative way/ code(s) to charge for non-intravenous sedation using inhalation of Nitrous Oxide. Is there any scope of charging, using ASA (CPT) codes if the patient also has medical insurance coverage apart from dental coverage?

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Asked on March 11, 2015
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You may code 00170 for the sedation and still use D9230 for the nitrous oxide to the medical carrier for reimbursement.

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Answered on March 12, 2015
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