D9110 - Emergency Palliat
Palliative treatment of dental pain – per visit.
- Procedure Code
- D9110
- Category
- Adjunctive
Insurance Verification Benchmarks & Billing Guidelines
Benchmark Policy Source: Delta Dental 2026
- Frequency Limitation
- Subject to group/individual contract frequency limitations (none)
Required Claim Attachments & Pre-Submission Checklist
- Standard ADA claim form with CDT procedure code and date of service
Bill When (Allowable Clinical Criteria)
- Indicated for medically and clinically necessary treatment as documented in patient's dental record.
Restrictions & Clinical Exclusions
- Infection control is included in the fee for the dental services provided. Separate fees are not billable to the patient.
- General anesthesia and intravenous sedation are limited to one hour. Any additional minutes are not billable to the patient unless clinical documentation supports more than an hour was necessary. For example, special health care needs patients may require additional units of anesthesia and may be a benefit according to group/individual contract.
- All services and treatment provided remotely via tele-health modalities, be they synchronous or asynchronous, must be performed by a licensed dentist or their supervised staff, acting within the scope of applicable law. Services and treatment delivered virtually are only a benefit when the elements included in the descriptor of the CDT procedure code are completed and only when they meet generally accepted clinical guidelines.
- Benefits for restorations for altering occlusion, adjusting vertical dimension, replacing tooth structure lost by attrition, erosion, abrasion, abfraction, corrosion, TMD, or for periodontal, orthodontic, or other splinting are denied, unless covered by group contract.
Common Claim Denial Codes & Overturn Strategies
| Denial Code | Denial Reason | Appeal & Overturn Strategy |
|---|---|---|
| CO-119 | Benefit maximum or frequency limitation exceeded for procedure | Submit clinical narrative detailing extraordinary circumstances, active recurrent pathology, or exception criteria. |
ICD-10 Justification & Crosswalk Mappings
| ICD-10 Code | Diagnosis Name | Category | Primary Justification | Claim Type | Clinical Scenario |
|---|---|---|---|---|---|
| K04.02 | Irreversible pulpitis | Diseases of pulp and periapical tissues | Yes (Primary) | BOTH | palliative treatment of dental pain – per visit indicated for Irreversible pulpitis |
| K02.53 | Dental caries on pit and fissure surface penetrating into pulp | Dental caries | Secondary | BOTH | palliative treatment of dental pain – per visit indicated for Dental caries on pit and fissure surface penetrating into pulp |
| K02.63 | Dental caries on smooth surface penetrating into pulp | Dental caries | Secondary | BOTH | palliative treatment of dental pain – per visit indicated for Dental caries on smooth surface penetrating into pulp |
| K04.01 | Reversible pulpitis | Diseases of pulp and periapical tissues | Secondary | BOTH | palliative treatment of dental pain – per visit indicated for Reversible pulpitis |
| K04.6 | Periapical abscess with sinus | Diseases of pulp and periapical tissues | Secondary | BOTH | palliative treatment of dental pain – per visit indicated for Periapical abscess with sinus |
| K04.7 | Periapical abscess without sinus | Diseases of pulp and periapical tissues | Secondary | BOTH | palliative treatment of dental pain – per visit indicated for Periapical abscess without sinus |
| M26.601 | Right, temporomandibular joint disorder, unspecified | Dentofacial anomalies [including malocclusion] | Secondary | BOTH | palliative treatment of dental pain – per visit indicated for Right, temporomandibular joint disorder, unspecified |
| M26.602 | Left temporomandibular joint disorder, unspecified | Dentofacial anomalies [including malocclusion] | Secondary | BOTH | palliative treatment of dental pain – per visit indicated for Left temporomandibular joint disorder, unspecified |
| M26.603 | Bilateral temporomandibular joint disorder, unspecified | Dentofacial anomalies [including malocclusion] | Secondary | BOTH | palliative treatment of dental pain – per visit indicated for Bilateral temporomandibular joint disorder, unspecified |
| M26.609 | Unspecified temporomandibular joint disorder, unspecified side | Dentofacial anomalies [including malocclusion] | Secondary | BOTH | palliative treatment of dental pain – per visit indicated for Unspecified temporomandibular joint disorder, unspecified side |
| M26.69 | Other specified disorders of temporomandibular joint | Dentofacial anomalies [including malocclusion] | Secondary | BOTH | palliative treatment of dental pain – per visit indicated for Other specified disorders of temporomandibular joint |