Current Dental Terminology (including procedure codes, nomenclature, descriptors and other data contained therein) is copyright © 2015 American Dental Association. The CDT Code and Nomenclature above have been obtained from Current Dental Terminology (including procedure codes, nomenclatures, descriptors and other data contained therein) ("CDT"). CDT is copyright © 2015 American Dental Association. All rights reserved. Applicable FARS/DFARS apply.

Claims Filing Instructions and Forms


Chapter 7(E) Dental Program Claims Filing

2006 ADA Claim Form Instructions

Sample 2006 ADA Claim Form

209-EPSDT Dental Adjustment / Void Form and Instructions

210-Adult Dental Adjustment / Void Form and Instructions

BHSF Form 9-M - Referral for pregnancy related Dental Services

Conscious Sedation Form

TMJ Summary