D9222 is the CDT code for deep sedation or general anesthesia, first 15 minutes. It is a time-based anesthesia code billed for the initial 15-minute increment. D9223 covers each subsequent 15 minutes. Anesthesia time is documented start to stop.
Last updated June 2026 · Reviewed by the PracticeAlpha billing team
Use D9222 for the first 15 minutes of deep sedation or general anesthesia administered in conjunction with a covered procedure. It is a time-based code. You bill D9222 once for the initial 15-minute block and then D9223 for each additional 15 minutes. The clock runs from documented start to stop, so the recorded anesthesia time decides how many units appear on the claim.
Common clinical scenarios: Surgical extraction of impacted third molars under general anesthesia. A patient with severe dental anxiety or special needs who cannot tolerate care under local anesthesia alone. Extensive oral surgery where deep sedation or general anesthesia is medically indicated and provided by a qualified provider.
Do NOT use D9222 for: Intravenous moderate (conscious) sedation (use D9239 for the first 15 minutes and D9243 for each subsequent block). Non-intravenous moderate sedation (use D9248). Nitrous oxide analgesia or anxiolysis (use D9230). Local anesthesia, which is part of the operative procedure and not separately billable.
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The initial 15-minute increment of deep sedation or general anesthesia. Billed once per case as the starting unit of anesthesia time.
Each additional 15-minute block after the first. Same depth of anesthesia, billed by the unit as the documented time grows beyond the opening increment.
Billing tip: These two work as a pair. Bill D9222 once for the first 15 minutes, then D9223 for every subsequent 15-minute block. The number of D9223 units has to match the documented start and stop times. A unit count that does not match the time record is a frequent denial.
D9222 is time-based, so the record has to show when the anesthesia began and ended. If the start and stop times are missing or vague, the payer cannot verify the units billed and the claim is denied. Document the clock time anesthesia started and the time it stopped on the anesthesia record for every case.
The number of D9222 and D9223 units has to line up with the documented time. Billing more increments than the start and stop times support is a common reason for a denial or a request for records. Count the units from the recorded duration, not from a default or an estimate.
Deep sedation and general anesthesia are billed in conjunction with a covered procedure. Without a qualifying surgical procedure and a narrative explaining why the anesthesia was medically necessary, many plans will not reimburse it. Tie the anesthesia to the procedure and document the clinical reason it was required.
Billing the deep sedation or general anesthesia tier when the record describes moderate sedation triggers denials and audits. D9222 is the deep tier. If the patient was kept responsive with IV moderate sedation, the correct codes are D9239 and D9243, not D9222. The depth documented in the anesthesia record has to match the code on the claim.
Record the clock time the provider began continuous attendance and the time it ended. These start and stop times are the primary support for the units billed under D9222 and D9223.
Document that the level was deep sedation or general anesthesia rather than moderate sedation. The record should make the depth and the route clear so the code matches what was provided.
Identify the covered procedure the anesthesia was provided for, such as a surgical extraction. The anesthesia is billed in conjunction with that procedure, so both should appear together.
Explain why deep sedation or general anesthesia was required, for example severe anxiety, special needs, or the extent of the surgery. A short narrative answers the most common payer question up front.
Include the intraoperative monitoring documentation appropriate to deep sedation or general anesthesia. This supports both the level billed and the standard of care for the case.
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Learn about our billing servicesD9222 is the CDT code for deep sedation or general anesthesia, first 15 minutes. It is a time-based anesthesia code billed for the initial 15-minute increment of deep sedation or general anesthesia administered in conjunction with a covered procedure. D9223 covers each subsequent 15 minutes.
D9222 covers the first 15 minutes of deep sedation or general anesthesia. D9223 covers each additional 15-minute increment after that first block. You bill D9222 once and then D9223 for every subsequent 15 minutes, based on documented start and stop times.
D9222 is the first 15 minutes of deep sedation or general anesthesia. D9239 is the first 15 minutes of intravenous moderate (conscious) sedation. The depth of sedation is the difference. Deep sedation and general anesthesia are a deeper level than IV moderate sedation.
Common reasons: missing documented anesthesia start and stop times, time units that do not match the documentation, sedation billed without a qualifying surgical procedure, no medical necessity narrative, and billing the deep sedation tier when only moderate sedation was performed.
Anesthesia time is documented from start to stop. The record should show the clock time the provider began continuous attendance and the time it ended. D9222 covers the first 15 minutes, and the total documented time decides how many D9223 units follow.
Yes. Deep sedation and general anesthesia are billed in conjunction with a covered procedure such as a surgical extraction. Most plans will not reimburse the anesthesia on its own without a qualifying procedure and a medical necessity narrative.
Search all 206 CDT codes in our dental coding guide.