Hi Guest!
Yep you got it on the procedure code side of it :)
As far as modifiers - there is not a standard modifier code you will need for surgical extractions, however if there is a special situation you might use one. For example:
-22 Unusual Procedural Services
-52 Reduced Services
You may want to consider using the JP qualifier.
Here is some additional information about the JO and JP qualifiers:
The following are the codes for tooth numbers, reported with the JP qualifier:
• 1 –32: Permanent dentition
• 51 –82: Permanent supernumerary dentition
• A –T: Primary dentition
• AS –TS: Primary supernumerary dentition
The following are the codes for areas of the oral cavity, reported with the JO qualifier:
• 00 : Entire oral cavity
• 01 : Maxillary arch
• 02 : Mandibular arch
• 10 : Upper right quadrant
• 20 : Upper left quadrant
• 30 : Lower left quadrant
• 40: Lower right quadrant
Examples of how this would look on the medical claim can be found in the NUCC's CMS 1500 claim form manual here, starting on page 46 & 47:
http://www.nucc.org/images/stories/PDF/1500_claim_form_instruction_manual_2012_02-v5.pdfHope this helps!