by Christine Woolstenhulme, CPC, CMRS, QCC, QMCS
In 2019 the ADA revised the ADA Dental claim form to incorporate editorial changes to further its consistency with the 837D. The previous update was in 2012, the changes in 2012 were made to incorporate the capability to report diagnoses codes.
Some of the important changes include Bx# 8 and 15, the description was updated to Policy Holder/Subscriber ID. Gender now has a third box to indicate an "Unknown" gender in Bx # 7, 14, and 22. The diagnosis for reporting ICD-9 has also been removed in Bx# 34 as it is no longer a valid diagnosis set.
Other editorial amendments to the claim form are listed below.
|Description updated to Policy Holder/Subscriber ID||8,15|
|Gender now has a third box to indicate an "Unknown" gender||7,14,22|
|The diagnosis for reporting ICD-9 has also been removed as it is no longer a valid diagnosis set.||34|
|Ares of Oral Cavity: Addition of NOTE that points to other online guidance on when this information is reported.||25|
|Tooth Numbers or Letters: Consistent instructions for reporting procedures involving multiple teeth.||27|
|Tooth Numbers or Letters Missing Teeth Remarks: Addition of NOTE to clarify that tooth numbers are based on morphology, not anatomic location.||27, 33, 35|
|Diagnosis Code List Qualifier-Removal of coding option “B” as it applies to an ICD-10-CM version that is no longer valid for use.||34|
Diagnosis Code List Qualifier Diagnosis Code(s): Addition of clarifying NOTE that: a) addresses when this information would be reported; and b) refers to other online guidance for completion when this information is reported.
Place of Service Code Treatment Location Address: Additional information concerning completion when teledentistry procedure code is reported.