Blue Cross Blue Shield FEP Dental Brochure - 2026
Blue Cross Blue Shield FEP Dental
General Services
General Services
Anesthesia Services
D9219 Evaluation for moderate sedation, deep sedation or general anesthesia
D9222 Administration of deep sedation/general anesthesia – first 15 minute increment, or any portion thereof - Up to 8 total units of anesthesia (combined with D9223 Administration of deep sedation/general anesthesia – each subsequent 15 minute increment, or any portion thereof)
D9223 Administration of deep sedation/general anesthesia – each subsequent 15 minute increment, or any portion thereof - Up to 8 total units of anesthesia (combined with D9222 Administration of deep sedation/general anesthesia – first 15 minute increment, or any portion thereof)
D9230 Administration of nitrous oxide - For children 5 and under and other individuals with a medical condition that may require it
D9239 Administration of moderate sedation – intravenous – first 15 minute increment, or any portion thereof - Up to 8 total units of anesthesia (combined with D9243 Administration of moderate sedation – intravenous – each subsequent 15 minute increment, or any portion thereof)
D9243 Administration of moderate sedation – intravenous – each subsequent 15 minute increment, or any portion thereof - Up to 8 total units of anesthesia (combined with D9239 Administration of moderate sedation – intravenous – first 15 minute increment, or any portion thereof)
D9222 Administration of deep sedation/general anesthesia – first 15 minute increment, or any portion thereof - Up to 8 total units of anesthesia (combined with D9223 Administration of deep sedation/general anesthesia – each subsequent 15 minute increment, or any portion thereof)
D9223 Administration of deep sedation/general anesthesia – each subsequent 15 minute increment, or any portion thereof - Up to 8 total units of anesthesia (combined with D9222 Administration of deep sedation/general anesthesia – first 15 minute increment, or any portion thereof)
D9230 Administration of nitrous oxide - For children 5 and under and other individuals with a medical condition that may require it
D9239 Administration of moderate sedation – intravenous – first 15 minute increment, or any portion thereof - Up to 8 total units of anesthesia (combined with D9243 Administration of moderate sedation – intravenous – each subsequent 15 minute increment, or any portion thereof)
D9243 Administration of moderate sedation – intravenous – each subsequent 15 minute increment, or any portion thereof - Up to 8 total units of anesthesia (combined with D9239 Administration of moderate sedation – intravenous – first 15 minute increment, or any portion thereof)