Learn more about CDT codes with dental OM Kyle Summerford.

Coding with Kyle: Nitrous oxide

Nov. 17, 2023
Learn more about 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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Kyle L. Summerford is a nationally recognized practice management guru, author, and lecturer. He is founder and president of Summerford Solutions Inc., and cofounder of Elite Dental Claims. Kyle also serves as editorial director of Dental Office Manager Digest e-newsletter. He lectures extensively to dentists and their staff on topics such as insurance coding and billing and useful practice management tips. Contact him at [email protected].

About the Author

Kyle L. Summerford

With more than 22 years of experience in dental, Kyle L. Summerford has a unique approach to case presentation and patient acceptance. As an OM and financial dental consultant, he leverages his knowledge to assist new and struggling dental practices. Through his education programs, Kyle empowers staff members with effective patient education skills and persuasion techniques. He has lectured at CE events and academic institutions. His expertise is further recognized through his column, Dental Coding with Kyle. He’s the founder of the Dental Office Managers Community. Visit his website at kylesummerford.com.