FYI

At Delta Dental, we understand that there has been some uncertainty regarding the billing of local anesthesia, particularly Oraquix. We want to set the record straight: providers cannot bill separately for local anesthesia in any form, including Oraquix.
 

The language in our handbooks

Both the DeltaCare® USA and Delta Dental PPO™ handbooks contain specific language regarding the use of anesthesia for scaling and root planing:

Periodontal scaling and root planing typically requires administration of local anesthesia by intramucosal injection. Topical anesthetics and other anesthetic preparations placed on the oral mucosa do not qualify as local anesthesia for scaling and root planing procedures. Documentation in the patient treatment record should include the type and volume of local anesthetic used, and the concentration of the vasoconstrictor, if present. If no local anesthetic was used, the progress notes must document “no local anesthesia used.”
 

Billing clarification

It’s essential to emphasize that this language was never intended to suggest that topical anesthetics, when used for scaling and root planing, could be separately billed to the patient. Delta Dental firmly believes that adequate anesthesia is necessary for effective scaling and root planing. Therefore, we consider all locally administered anesthesia—whether via intramucosal injection, topical application or other means—to be included in the fee for the procedure. Separate billing for anesthesia is not permissible.

For further clarification and detailed information, we encourage providers to log in to Provider Tools and access the dentist handbook in the reference library. If you have any questions or need additional guidance, please don’t hesitate to reach out to our support team.