Pain Management and Dental Coding Guide
Published by the American Dental Coders Association
Pain is one of the most common reasons patients seek dental care — and managing that pain effectively is a top priority for both clinicians and coders. But when it comes to documenting, coding, and billing for pain-related procedures, things can get complex.
This guide is designed to help dental billing and coding professionals navigate the nuances of pain management—from understanding the clinical context to assigning accurate CDT and ICD-10 codes. Whether you work in a general dentistry office or a surgical specialty, coding correctly for pain management ensures timely reimbursement and compliance.
Learn more with the Certified Dental Billing Specialist (CDBS) and Certified Dental Coder (CDC) programs through the American Dental Coders Association, or explore our Dual Certification Program.
What Is Dental Pain Management?
Pain management in dentistry encompasses a range of treatments and procedures aimed at reducing or eliminating oral pain. These services may include:
- Palliative care (non-definitive, symptom-relieving treatment)
- Local anesthesia or nerve blocks
- Post-operative pain control
- Management of chronic pain conditions like TMJ
- Emergency care for acute oral pain
Common CDT Codes Used in Pain Management
- D9110 – Palliative (emergency) treatment of dental pain – minor procedure
- D0140 – Limited oral evaluation – problem focused
- D0170 – Re-evaluation – limited, problem focused (not post-operative)
- D0220 – Periapical x-ray (first image)
- D0230 – Additional periapical x-ray
- D9215 – Local anesthesia not in conjunction with operative or surgical procedures
- D9610 – Therapeutic drug injection, by report
- D9230 – Inhalation of nitrous oxide/analgesia, anxiolysis
- D9999 – Unspecified procedure, by report
Tip: Always link CDT codes with ICD-10 diagnostic codes to justify the medical necessity for the treatment provided.
ICD-10 Diagnostic Codes for Dental Pain
- K08.8 – Other specified disorders of teeth and supporting structures
- K05.6 – Periodontal disease, unspecified
- K04.7 – Periapical abscess without sinus
- K13.79 – Other lesions of oral mucosa
- R52 – Pain, unspecified
- M26.60 – Temporomandibular joint disorder, unspecified
Coding Scenarios for Pain Management
1. Emergency Visit for Toothache
- CDT: D9110 + D0140 + D0220/D0230
- ICD-10: K08.8 (tooth pain)
2. Injection for Post-Extraction Pain
- CDT: D9610 or D9999
- ICD-10: K04.7
3. TMJ Disorder with Pain Symptoms
- CDT: D0140, D9230
- ICD-10: M26.60
Important Considerations When Billing for Pain Management
- Payer policies vary – Not all payers reimburse for palliative care or anesthesia separately.
- Documentation is critical – Always include SOAP notes, especially for emergency or one-time visits.
- Emergency billing may require narratives – Add supporting documentation for D9110 and D0140 claims.
- Cross coding may apply – Pain caused by trauma or medical conditions may be billed to medical insurance.
Certify Your Skills in Dental Coding and Billing
- Certified Dental Billing Specialist (CDBS)
- Certified Dental Coder (CDC)
- Dual Certification Program
- Certified Dental Billing Specialist Exam
- Certified Dental Coder Exam
Final Thoughts
Pain management is not only a critical clinical concern — it’s also a complex billing category. Dental billing and coding professionals must understand how to document, code, and justify treatment to ensure proper reimbursement and regulatory compliance.
By learning the appropriate CDT and ICD-10 codes and staying up-to-date with payer rules, you can confidently code for pain-related services and help your practice run more efficiently.