D9613 is the CDT code for infiltrating a slow-release pain medication at a surgical site for long-acting pain control, billed per quadrant.
- When to use: A long-acting analgesic such as liposomal bupivacaine was infiltrated at the surgical site, often after third molar removal, to control pain at home.
- When not to use: Local anesthetic given for the procedure is D9215 or D9210, and an injected antibiotic or steroid is D9610, or D9612 for two or more drugs.
- Billing note: Post one line per quadrant with its area code, since stacked or untagged units deny as duplicates, and some carriers exclude the code outright.
What D9613 covers
D9613 reports a slow-release pain medication infiltrated into the soft tissue at a surgical site so the patient stays comfortable long after the appointment. The drug is a long-acting local analgesic, typically a liposomal bupivacaine formulation that releases gradually over a day or more as the carrier breaks down. Oral surgeons and periodontists use it to control post-operative pain and to reduce how much opioid analgesic a patient needs at home.
Two facts set it apart from the rest of the therapeutic drug block:
- The drug is a sustained-release analgesic placed at the surgical site. D9610 and D9612 report a therapeutic drug given to treat a condition, such as an antibiotic, a steroid, or an antiemetic, by any parenteral route. The difference is what the drug is for, not how far it travels.
- The unit is the quadrant. The code is reported once for every quadrant that received the drug, not once for the visit.
The distinguishing axis: pain control after surgery, not numbing for it
The nearest confusion is with local anesthesia, because both are injections in the same part of the mouth at the same appointment.
Local anesthesia lets the dentist operate. It goes in first, wears off in a couple of hours, and is reported with D9215 when a procedure was performed that day or D9210 when nothing was. Both are almost always included in the fee for the procedure they supported.
The sustained-release drug is placed for the pain the patient will have tonight and tomorrow, after the anesthetic wears off. That is why it stands as its own line rather than sitting inside the surgical fee. The code’s own definition states it is not for local anesthesia purposes, and carrier policies repeat that exclusion.
The per-quadrant unit, and how quadrants reach the claim
D9610 and D9612 are visit-level codes: you pick one based on how many different drugs were given and report it once. D9613 is one of three codes the ADA calls quadrant codes that do not specify a range of teeth. The other two are D4263 for a bone replacement graft and D4921 for gingival irrigation.
The ADA defines a quadrant as one of the four equal sections of the arches, running from the midline back to the last tooth. A case that infiltrates the drug around impacted third molars in all four corners of the mouth supports four units on one date of service.
ADA guidance for these codes is that the record and the claim must carry as many separate code and area-of-the-oral-cavity combinations as it takes to report everything delivered. The area codes are 10 for the upper right, 20 for the upper left, 30 for the lower right, and 40 for the lower left.
Why it gets denied
Denials fall into three groups that call for different responses.
Flat non-coverage on clinical grounds. At least one major carrier’s current dental policy states that infiltration of a sustained-release therapeutic drug is not indicated because the evidence for its effectiveness and safety is insufficient. No narrative moves a coverage position, so the practice needs the answer before the drug is used, because the cost lands on the patient or the practice.
No benefit for drug administration. Many plans carry no benefit for in-office drug administration and deny the whole family, D9610 through D9630, as a category.
Unidentified quadrants. The units billed exceed what the claim’s quadrant data supports, so the extra lines deny as duplicates. This is the one the billing office controls.
Coverage varies more here than on most adjunctive services, because carriers disagree about whether the drug is worth using at all. Verify the specific plan before the case, and tell the patient about any balance if it is not a covered benefit.
When to bill D9613, and when not to
Bill it when the dentist infiltrates a sustained-release analgesic at the surgical site for extended post-operative pain control. The usual cases:
- Third molar removal, especially the impacted cases coded D7220 through D7241. Those are also the extraction codes carrier policies on this drug tend to key on.
- Periodontal surgery, where treatment is already organized by quadrant.
- Any oral surgery where the plan is to keep the patient off opioid analgesics.
Do not bill it for:
- The local anesthetic that made the procedure possible (D9215, or D9210 with no procedure).
- A therapeutic drug injected systemically, such as an antibiotic or a steroid for swelling. One drug is D9610, and two or more different drugs at one visit is D9612.
- Medication sent home with the patient, which is D9630.
- More quadrants than were treated. Rounding a two-quadrant case up to four draws post-payment review.
Palliative treatment for a patient who arrives in pain is a separate service, D9110, and does not belong on a surgical date alongside this code.
Documentation that supports the claim
The record has to show that a sustained-release agent was used for post-operative pain and how many quadrants received it.
- The drug by name, with concentration and volume. A note reading only “long-acting anesthetic” does not establish the sustained-release formulation the code depends on.
- Each quadrant treated, named individually. “Infiltrated bilaterally” does not tell a reviewer whether that was two quadrants or four.
- The surgical procedure the drug supported, and why extended pain control suited this patient.
- The local anesthetic used for the procedure, recorded separately, so the D9613 line does not read as a second bill for the numbing injection.
None of this wins an appeal against a coverage position, but the same record supports the units when the denial is a duplicate-line problem.
Practice software setup
- Set D9613 as a quadrant-level code. A treatment-area flag set to quadrant makes the software prompt for the area on every line, which prevents the most common fixable denial on this code.
- Cap quantity at one per line, where the system allows it, so nobody posts a four.
- Label it away from the anesthesia codes, for example “sustained-release post-op analgesic, per quadrant.” A label reading “bupivacaine” next to the local anesthesia codes eventually gets picked for the numbing injection.
The fee is modest, but a single case can carry four units, and multi-unit lines get reviewed. For how the quadrant field and other line-level data reach the payer, see the ADA dental claim form guide.
FAQs
- What is the dental code for a sustained release drug?
- D9613. It reports infiltrating a slow-release pain medication, usually a liposomal bupivacaine formulation, into the tissue at a surgical site so pain control lasts well past the appointment. It is reported once for each quadrant that received the drug, not once per visit. Its neighbors in the therapeutic drug block are D9610 for a single injected therapeutic drug, D9612 for two or more different injected drugs, and D9630 for medication handed to the patient for home use.
- Can you bill D9613 more than once on the same date?
- Yes, when more than one quadrant was treated. A case that infiltrates the drug in all four quadrants supports four units. Report each unit on its own line tagged with its quadrant code: 10 for upper right, 20 for upper left, 30 for lower right, 40 for lower left. Whether the plan pays every unit depends on the contract.
- What is the difference between D9613 and D9215?
- What the drug is for. D9215 is local anesthesia given so the dentist can perform the procedure, and carriers almost always include it in that procedure's fee. D9613 is a long-acting drug infiltrated for pain control after the procedure is over. Carrier policies commonly state that D9613 does not cover local anesthesia used before and during treatment, so billing it for the numbing injection loses the line and invites a look at the rest of the claim.
- What is the difference between D9613 and D9610?
- Delivery and unit. D9610 is a single therapeutic drug given by injection, such as an antibiotic, steroid, anti-inflammatory, or antiemetic, to treat a clinical problem during the visit, and it is one unit per visit. D9613 is a slow-release drug infiltrated into the soft tissue at the surgical site for extended pain control, counted per quadrant. A steroid injected in the arm for swelling is D9610. A long-acting analgesic infiltrated around extraction sites in two quadrants is two units of D9613.
- Why was D9613 denied?
- Usually for one of three reasons, and only the last is fixable by the billing office. Some carriers consider the evidence for sustained-release infiltration insufficient and do not cover it at all, which no narrative will move. Some plans carry no benefit for drug administration. And some deny extra units because the claim billed multiple quadrants without identifying them, so the added lines read as duplicates. Identify which denial you got before writing an appeal.
- Is D9613 still a valid CDT code in 2026?
- Yes. D9613 is active in CDT 2026 and was not added, deleted, or revised that year. The CDT 2022 revision changed it to a per-quadrant unit from a version that described single or multiple sites with no quadrant count. Carrier policy documents written before that revision still circulate, so a plan's published policy may describe the unit differently from the current code. D9610, D9612, and D9630 also carried through CDT 2026 unchanged.
Related codes
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CDT codes are maintained by the American Dental Association. This page is an editorial billing guide, not the official ADA code descriptor. Verify current coverage policies with each carrier before submitting claims.