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Page Properties

Number

0120

Submitting Entity (SE)

67369D

Add Date

Update Date

Update

Included in Feb 2024 data tips email

Description

Dental procedures often involve more than one tooth.  Teeth are identified by number.  All tooth numbers involved in a procedure should be listed together on the claim line in the Tooth Number (DC047) field, separated by commas. 

Cigna 67369D does not include all tooth numbers on a single claim line but provides a claim line for each tooth number.  See this example:

  • Row Number (DC999) - 342

    • Claim Number (DC004) - E55775410P001

    • Claim Line (DC005) - 1

    • Tooth Number (DC047) - NULL

  • Row Number (DC999) - 309

    • Claim Number (DC004) - E55775410P001

    • Claim Line (DC005) - 1

    • Tooth Number (DC047) - 3

  • Row Number (DC999) - 320

    • Claim Number (DC004) - E55775410P001

    • Claim Line (DC005) - 1

    • Tooth Number (DC047) - 5

Active/Resolved

Active

Action / Resolution

Category 1

Dental

Category 2

ToothNubmer

Tip / Issue

Tip