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Saly
#1 Posted : Thursday, January 26, 2023 3:10:55 PM(UTC)
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Hello,

A dental anesthesiologist is partnering with Pediatric dentists in a ASC- Ambulatory Surgery Centers and I need help billing services please to medicaid in VA. We bill the dental codes for anesthesia - D9222 and D9223- etc.. but I am trying to understand how to bill the CPT 41899 and EPG etc to get reimbursement for the facility as well.

Can anyone help me understand how the medical billing works to get the full reimbursement for the facility?

Much appreciated for any help that you can give me.

First time medical billing:)
courtneydsnow
#2 Posted : Monday, February 20, 2023 11:05:24 AM(UTC)
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courtneydsnow

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Hi Saly!

We're certainly happy to help where we can.

So, just a heads up if the services being rendered are medically necessary, there are crosscodes to medical (CPT) for the anesthesia codes:

D9222 – deep sedation/general anesthesia – first 15 minutes
and
D9223 – deep sedation/general anesthesia – each additional 15 minutes
can be crosscoded to:

00170 - Anesthesia for intraoral procedures, including biopsy; not otherwise specified
00172 - Anesthesia for intraoral procedures, including biopsy; repair of cleft palate
00174 - Anesthesia for intraoral procedures, including biopsy; excision of retropharyngeal tumor
00176 - Anesthesia for intraoral procedures, including biopsy; radical surgery


As for the EPG (Electropalatography) - there is not a specific medical code we're aware of, so you may consider an unlisted code and use a narrative description to describe what procedure the code is being used to represent, for example:
42299 - Unlisted procedure, palate, uvula
41599 - Unlisted procedure, tongue, floor of mouth
40899 - Unlisted procedure, vestibule of mouth


When billing to medical insurance from an ASC - the place of service code is 24.

As for CPT 41899, that code stands for: unlisted procedure, dentoalveolar structures. So, in short, it can represent any procedure that happens relating to a tooth and the alveolar bone that doesn't have it's own specific CPT code! Like the unlisted codes above, you would explain in your narrative report what procedure the is being used to represent.

Hope this helps!
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