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Nitrous Oxide

How to use code D9230 to submit insurance claims for patients who benefit from the use of nitrous oxide.


Code D9230 is to be used for inhalation of nitrous oxide/analgesia, anxiolysis.

Insurance reimbursements depend on a well-documented narrative indicating the necessity for providing nitrous oxide to your patient. If additional time was spent with the patient due to anxiety or behavior control, report D9920: Behavior management, by report in addition to D9230 for each additional fifteen minutes spent to ease the patient to be able to provide dental care.

A narrative detailing the following points can help facilitate payment, should the procedures be covered by the patient’s dental plan.

  • High levels of anxiety required the use of nitrous oxide due to patient phobia

  • Nitrous oxide was required to obtain full cooperation of the patient during the dental visit

  • The procedure required additional time due to behavioral management issues and to obtain full cooperation of the patient.

  • The administration of nitrous oxide was successful in allowing the restoration to occur and provided the patient with a favorable prognosis.

  • Without administration of nitrous oxide, the procedure could not have been completed as it was a necessity for behavioral management.

Finally, be sure to document the patient’s record should all or some of the reasons for necessity apply and submit current radiographs and periodontal charting from within the last six months if required.



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