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Nitrous Oxide Prior Authorization Requirement Change

CTDHP Prior Authorization Requirement Change:

D9230  Analgesia, Anxiolysis, Inhalation: Nitrous Oxide

For dates of service June 1st 2013 and later, Pediatric Dentists using Nitrous Oxide for behavior management purposes are no longer required to receive prior authorization or post-procedure authorization in order to bill for this procedure code.  Claims for D9230 may now be submitted directly to Hewlett-Packard (HP) for payment.

Note that the coverage guidelines described below continue to apply and practitioners are responsible to maintain documentation of developmental delays or other conditions necessitating the use of nitrous oxide in their patients' charts for those patients age nine and over.

D9230 is covered for clients under the age of nine (prior to ninth birthday), or clients of any age who have a diagnosis such as autism, cerebral palsy, hyperactivity disorder or developmental delay with a demonstrated need for behavior management related to the dental procedures to be performed.  D9230 is not a covered benefit for clients twenty-one or over for dental services.  It is not a covered benefit for clients age nine (9)  or over for the extraction of a single tooth or general dental services.




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