Instructions
Instructions
Thank you for your interest in submitting a change request. In
order for your request to be considered,
it is necessary to complete the appropriate Code
Change Request
Form (Addition / Revision / Deletion) by using a printed form that can
be returned by email, or by "fax" or mail.
Please consider the following as you complete either version of
the request.
- A separate request is required
for each desired action on
the Code.
- Provide substantive
justification for proposing the request.
Please avoid reasons such
as "no
code currently available."
- Include vignettes, if helpful.
A vignette
must include the following information:
- Description
of the typical patient for whom the procedure
is used
- Description of the clinical procedure itself
- An indication whether it is appropriate to
report the procedure with any others
- For a stand-alone procedure a note on other
procedures that
must be reported
at the same time, and those
which must not.
- When requesting a new procedure code that represents
new technology, attach available supporting
peer-reviewed literature.
- Attach literature, when available,
indicating widespread usage and acceptance of the
procedure.
- When requesting
a deletion, provide an alternate code that is not an
unspecified code for reporting
the procedure. If there
is no alternative or the procedure is believed to be
obsolete, express this in writing.
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Components of A Dental Procedure Code
The following information is provided to assist completion
of your Code change request.
An individual dental procedure code as currently defined
has at least the first two
of the following three components. References
to typeface pertain to the Code as
printed in the "CDT" manual.
- Dental Procedure Code (Code)–A five character alphanumeric
code that begins with
the letter “D” and is followed
by four numerals. Each
code identifies a specific dental procedure, and is printed
in boldface
type.
- Nomenclature–A brief written definition of a Dental
Procedure Code. Each
code must have Nomenclature that
is printed in boldface type.
- Descriptor–A written narrative that provides further
definition and the
intended use of a Dental Procedure
Code. A Descriptor is optional and
is printed in regular type.
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Transmitting Your Code Change Request
Via the Internet: The Code
Change Request is a Microsoft Word file© Document that
may be downloaded and completed at
your convenience. We encourage the
return of the completed form as an
attachment to dentalcode@ada.org.
Supporting information in electronic form may also be sent
as email attachments to the same address.
FAX: The Code
Change Request as well as any
supporting information can be sent via “fax” to the
ADA Council on Dental Benefit Programs, Attn:
Code Change Requests at 312-440-2520.
Regular Mail: Should the US Postal service or premium overnight
mail service be preferred, documents should be sent to the following
address:
American Dental Association
Council on Dental Benefit Programs
211 East Chicago Avenue
Chicago, IL 60611
Attn: Code Change Requests
Questions: Please direct your questions concerning
code change request submission to Council
staff via telephone 312-440-2753, fax
312-440-2520 or e-mail dentalcode@ada.org.
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