Key points
- Enter procedure dates and CDT codes from the completed treatment documentation and coding workflow.
- Not every CDT code uses tooth or surface information.
- For claims with several procedures, review dates, tooth information, fees, diagnosis information when applicable, and totals across all lines.
Start with the treatment record
Enter procedure dates and CDT codes from the completed treatment documentation and coding workflow. Do not use the claim form to reconstruct treatment from memory.
Tooth and surface detail must fit the procedure
Not every CDT code uses tooth or surface information. When those details are applicable, make sure the notation corresponds to the documented tooth or area and the code being reported.
Keep multi-line claims internally consistent
For claims with several procedures, review dates, tooth information, fees, diagnosis information when applicable, and totals across all lines. Copy-and-edit workflows are efficient but can leave an old tooth number or date behind.
Dental-claim review
- For actual services, match procedure dates to the clinical record; predetermination requests are handled differently.
- Review tooth number/letter, oral-cavity area, and tooth surface only when applicable to the reported procedure.
- Keep procedure code, tooth information, quantity, fee, and diagnosis pointer aligned on each service line.
Sources and verification
Use the ADA source below for the current 2024 Dental Claim Form and completion guidance, together with the dental plan’s requirements.
Related guides
- Subscriber and Insurance Information on Dental Claims
- Diagnosis Information on Dental Claims
- Patient Information on the ADA Dental Claim Form
Try the software
MedClaimSoftware’s ADA Dental Claim program is designed for the current 2024 form and can save/retrieve claim data and print from Windows. A limited-use trial is available without a credit card. ADA Dental Claim software.