Ask the Coding Coach: CDT Code Changes for 2026
Each year, the CDT procedure codes are reviewed and revised as needed. For 2026, the biggest changes occurred with the codes for anesthesia. There was a complete revision of the anesthesia codes, with several codes being added while others were revised or deleted. It is important to review the changes and submit claims according to the new definitions and changes.
This article provides a summary, but refer to the CDT 2026 coding book for full detail and descriptors. All the anesthesia codes are found in the adjunctive services category (9000-series codes).
A general understanding of important terms is essential. Two things determine the correct code for anesthesia: the route of administration and the depth of anesthesia.
- Enteral: medication is absorbed through GI tract or oral mucosa (oral sedation)
- Parenteral: medication bypasses GI tract (intramuscular or intravenous sedation)
The depth of anesthesia is determined by the provider and the effect on the central nervous system.
- Minimum sedation: the patient feels relaxed, drowsy, and comfortable, yet remains fully awake. Patient is able to independently and continuously maintain an airway and able to respond normally to tactile stimulation and verbal commands.
- Moderate sedation: a drug-induced depression of consciousness during which patients respond purposefully to verbal commands, either alone or accompanied by light tactile stimulation. No interventions are required to maintain a patent airway, and spontaneous ventilation is adequate.
- Deep sedation/general anesthesia: a drug-induced depression of consciousness during which patients cannot be easily aroused but respond purposefully following repeated or painful stimulation. The ability to independently maintain ventilatory function may be impaired. Patients may require assistance in maintaining a patent airway, and spontaneous ventilation may be inadequate.
Anesthesia Codes
Effective January 1, 2026, all anesthesia codes include nitrous oxide if used along with other drugs. The stand-alone nitrous oxide code (D9230) should only be used when that is the only drug administered. For all other codes, nitrous oxide is included.
Although there are definitions for levels of sedation, the level is determined by the provider that administers the sedation. Time of sedation starts when the drugs are given and ends when the patient can be left with trained personnel.
Note that as part of the changes to these codes, D9248 (non-intravenous conscious sedation) has been deleted. Use the current appropriate code based on the type of anesthesia used.
D9230 administration of nitrous oxide
This code was revised and is used when nitrous oxide is given as a single agent.
D9244 in-office administration of minimal sedation – single drug – enteral
This code is new and should be used for oral administration of an agent such as Valium or Halcion.
D9245 administration of moderate sedation – enteral
This code is new and should be used when sedation is achieved by using one or more drugs that are taken orally in the office.
D9246 administration of moderate sedation – non-intravenous parenteral – first 15-minute increment or any portion thereof
This code is new and should be used when moderate sedation is obtained by a parenteral route such as intramuscular injection. It can be one or more drugs.
D9247 administration of moderate sedation – non-intravenous parenteral – each subsequent 15-minute increment, or any portion thereof.
This code is new and should be used in conjunction with D9246.
D9239 administration of moderate sedation – intravenous – first 15-minute increment, or any portion thereof
This code is revised and should be used when moderate sedation is obtained intravenously. Drugs are titrated to achieve the desired level of sedation.
D9243 administration of moderate sedation – intravenous – each subsequent 15-minute increment, or portion thereof.
This code is revised and should be used in conjunction with D9239.
D9222 administration of deep sedation/general anesthesia – first 15-minute increment, or any potion thereof.
This code is revised and should be used when the patient achieves a deeper level of sedation but does not require assistance for breathing
D9223 administration of deep sedation/general anesthesia – each subsequent 15-minute increment, or any portion thereof.
This code is revised and should be used in conjunction with D9222.
D9224 administration of general anesthesia with advanced airway – first 15-minute increment, or any portion thereof.
This is a new code. An advanced airway means intubation such as placement of an endotracheal tube.
D9225 administration of general anesthesia with advanced airway – each subsequent 15-minute increment, or any portion thereof.
This is a new code and should be used in conjunction with D9224.
Additional Code Changes
There are other changes that affect submitting codes for procedures which periodontists perform.
New Codes:
D0461 testing for cracked tooth
Includes multiple teeth and contra lateral comparisons, as indicated. Diagnostic aids may include but are not limited to pressure sensitivity testing, transillumination staining, etc.
D6280 implant maintenance procedures when a full arch removable implant/abutment supported denture is removed and reinserted, including cleansing of prosthesis and abutment – per arch
D6049 scaling and debridement of a single implant in the presence of peri-implantitis inflammation, bleeding upon probing and increased pocket depths, including cleaning of the implant surfaces without flap entry and closure This procedure is not performed in conjunction with D1110, D4910, or D4346.
D6196 removal of an indirect restoration on an implant retained abutment Not to be used for a temporary, provisional or screw retained restoration.
Revised Code:
D0180 comprehensive periodontal evaluation – new or established patient The descriptor was changed to emphasize full mouth probing and to include periodontal evaluation for patients with systemic medical conditions or social risk factors. It also includes an evaluation of current dental conditions.
Submit your third-party questions to [email protected]. Members with coding questions or difficulties with insurance claims can also contact the AAP’s Third-Party Specialist at 312-573-3241 or [email protected].
Claim Attachments at-a-Glance
Don’t forget this great resource to assist submitting the correct attachments with insurance claims. Find it on AAP Connect > Member Resource Library > Insurance Reimbursement and Third Party Issues
Each year, the CDT procedure codes are reviewed and revised as needed. For 2026, the biggest changes occurred with the codes for anesthesia. There was a complete revision of the anesthesia codes, with several codes being added while others were revised or deleted. It is important to review the changes and submit claims according to the new definitions and changes.
This article provides a summary, but refer to the CDT 2026 coding book for full detail and descriptors. All the anesthesia codes are found in the adjunctive services category (9000-series codes).
A general understanding of important terms is essential. Two things determine the correct code for anesthesia: the route of administration and the depth of anesthesia.
- Enteral: medication is absorbed through GI tract or oral mucosa (oral sedation)
- Parenteral: medication bypasses GI tract (intramuscular or intravenous sedation)
The depth of anesthesia is determined by the provider and the effect on the central nervous system.
- Minimum sedation: the patient feels relaxed, drowsy, and comfortable, yet remains fully awake. Patient is able to independently and continuously maintain an airway and able to respond normally to tactile stimulation and verbal commands.
- Moderate sedation: a drug-induced depression of consciousness during which patients respond purposefully to verbal commands, either alone or accompanied by light tactile stimulation. No interventions are required to maintain a patent airway, and spontaneous ventilation is adequate.
- Deep sedation/general anesthesia: a drug-induced depression of consciousness during which patients cannot be easily aroused but respond purposefully following repeated or painful stimulation. The ability to independently maintain ventilatory function may be impaired. Patients may require assistance in maintaining a patent airway, and spontaneous ventilation may be inadequate.
Anesthesia Codes
Effective January 1, 2026, all anesthesia codes include nitrous oxide if used along with other drugs. The stand-alone nitrous oxide code (D9230) should only be used when that is the only drug administered. For all other codes, nitrous oxide is included.
Although there are definitions for levels of sedation, the level is determined by the provider that administers the sedation. Time of sedation starts when the drugs are given and ends when the patient can be left with trained personnel.
Note that as part of the changes to these codes, D9248 (non-intravenous conscious sedation) has been deleted. Use the current appropriate code based on the type of anesthesia used.
D9230 administration of nitrous oxide
This code was revised and is used when nitrous oxide is given as a single agent.
D9244 in-office administration of minimal sedation – single drug – enteral
This code is new and should be used for oral administration of an agent such as Valium or Halcion.
D9245 administration of moderate sedation – enteral
This code is new and should be used when sedation is achieved by using one or more drugs that are taken orally in the office.
D9246 administration of moderate sedation – non-intravenous parenteral – first 15-minute increment or any portion thereof
This code is new and should be used when moderate sedation is obtained by a parenteral route such as intramuscular injection. It can be one or more drugs.
D9247 administration of moderate sedation – non-intravenous parenteral – each subsequent 15-minute increment, or any portion thereof.
This code is new and should be used in conjunction with D9246.
D9239 administration of moderate sedation – intravenous – first 15-minute increment, or any portion thereof
This code is revised and should be used when moderate sedation is obtained intravenously. Drugs are titrated to achieve the desired level of sedation.
D9243 administration of moderate sedation – intravenous – each subsequent 15-minute increment, or portion thereof.
This code is revised and should be used in conjunction with D9239.
D9222 administration of deep sedation/general anesthesia – first 15-minute increment, or any potion thereof.
This code is revised and should be used when the patient achieves a deeper level of sedation but does not require assistance for breathing
D9223 administration of deep sedation/general anesthesia – each subsequent 15-minute increment, or any portion thereof.
This code is revised and should be used in conjunction with D9222.
D9224 administration of general anesthesia with advanced airway – first 15-minute increment, or any portion thereof.
This is a new code. An advanced airway means intubation such as placement of an endotracheal tube.
D9225 administration of general anesthesia with advanced airway – each subsequent 15-minute increment, or any portion thereof.
This is a new code and should be used in conjunction with D9224.
Additional Code Changes
There are other changes that affect submitting codes for procedures which periodontists perform.
New Codes:
D0461 testing for cracked tooth
Includes multiple teeth and contra lateral comparisons, as indicated. Diagnostic aids may include but are not limited to pressure sensitivity testing, transillumination staining, etc.
D6280 implant maintenance procedures when a full arch removable implant/abutment supported denture is removed and reinserted, including cleansing of prosthesis and abutment – per arch
D6049 scaling and debridement of a single implant in the presence of peri-implantitis inflammation, bleeding upon probing and increased pocket depths, including cleaning of the implant surfaces without flap entry and closure This procedure is not performed in conjunction with D1110, D4910, or D4346.
D6196 removal of an indirect restoration on an implant retained abutment Not to be used for a temporary, provisional or screw retained restoration.
Revised Code:
D0180 comprehensive periodontal evaluation – new or established patient The descriptor was changed to emphasize full mouth probing and to include periodontal evaluation for patients with systemic medical conditions or social risk factors. It also includes an evaluation of current dental conditions.
Submit your third-party questions to [email protected]. Members with coding questions or difficulties with insurance claims can also contact the AAP’s Third-Party Specialist at 312-573-3241 or [email protected].
Claim Attachments at-a-Glance
Don’t forget this great resource to assist submitting the correct attachments with insurance claims. Find it on AAP Connect > Member Resource Library > Insurance Reimbursement and Third Party Issues