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Dental claims use their own code set and claim transaction. This page covers the CDT procedure codes, the 837D claim, the paper ADA Dental Claim Form, and the attachment workflow. Together, these are the principal differences from medical billing’s 837P process. For segment-level structure, see 837D file anatomy. The CDT code set updates every January 1. Verify current-year changes against the ADA before relying on any code-level detail.

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CDT: the dental procedure code set

CDT, commonly expanded as Current Dental Terminology and formally named the Code on Dental Procedures and Nomenclature, is maintained and copyrighted by the American Dental Association. Each code consists of a “D” followed by four digits. The codes are organized into twelve service categories:1 HIPAA designation. 45 C.F.R. § 162.1002(a)(4) designates the CDT as the HIPAA standard code set for dental services; every standard electronic dental claim must carry CDT codes.2 Update cycle. The ADA’s Code Maintenance Committee revises the CDT annually, effective January 1, and claims must use the version in effect on the date of service. So practice management systems and clearinghouses roll code tables every year-end. The CDT 2026 cycle carried 60 changes, including an anesthesia-code overhaul.3 Licensing. The ADA is the exclusive copyright owner and licenses commercial use (software vendors, payers, publishers). Purchasing the CDT manual carries the right to use the codes in your own practice and PMS; reproducing the code list, creating derivative works, or commercial redistribution requires an ADA license.4 Accordingly, this page describes the system’s structure and uses only illustrative codes. The wiki applies the same approach to CPT.

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The 837D vs. the 837P

The 837D (X12N 837 Health Care Claim: Dental, version 005010X224A2) is the 837P’s sibling with dental-specific content:5 There are two operational consequences. Clearinghouse support varies: dental-focused clearinghouses such as DentalXChange and Vyne/Tesia combine the 837D, attachments, and real-time eligibility in one workflow, while broader medical networks may handle attachments separately.6 A group running both medical and dental entities needs systems that support both formats; see Choose a clearinghouse.

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The ADA Dental Claim Form

The current paper form is the 2024 ADA Dental Claim Form, effective January 1, 2024. The 2024 revision added fields for locum tenens (temporary substitute) dentist reporting, the date of the patient’s last scaling and root planing, and the benefit plan’s Payer ID.7

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Current attachment workflows and the 2026 rule

Dental payers routinely require radiographs, periodontal charts, narratives, and photos before adjudicating crowns, scaling and root planing, or implants. Because HIPAA did not specify a claims-attachment transaction for decades, proprietary workflows became common. In the NEA FastAttach workflow, the practice uploads documentation, receives an NEA number, and places that number in the claim remarks so the payer can retrieve the attachment.8 DentalXChange offers a separate integrated attachment service. On March 24, 2026, CMS finalized a HIPAA claims-attachment standard (91 Fed. Reg. 14350). It adopts the X12N 275 transaction (version 006020X314) for transmitting attachments, the X12N 277 RFAI for payer requests for additional information, and HL7 CDA templates for the content. The compliance date is May 26, 2028. The final rule covers claims attachments but not prior-authorization attachments.9 Before signing a multi-year clearinghouse or PMS contract, ask for the vendor’s 275 implementation plan, expected fees, and testing dates. See Dental attachments for the vendor workflows, request-for-information cycle, and rule details.

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Eligibility, remittance, and the rest of the stack

The surrounding X12 transactions include 270/271 eligibility, 276/277 claim status, and 835 remittance. See X12 transaction sets and 835 anatomy. Dental-specific behavior appears in the content, including downgrades and frequency limits that may resemble denials but reflect the member’s benefit design. See Bill dental claims for the operational workflow.

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Teledentistry codes

CDT includes synchronous (D9995) and asynchronous (D9996) teledentistry codes, effective since CDT 2018, reported in addition to the underlying clinical procedure code.10

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Sources

  1. Category structure per the ADA’s CDT introduction as reproduced by the AAPD: Chapter 1 (PDF); ADA CDT publications: ada.org/publications/cdt.
  2. 45 C.F.R. § 162.1002(a)(4). CFR text (LII); eCFR.
  3. ADA News, 60 changes coming to CDT Code in 2026; Delta Dental, CDT 2026 provider notice.
  4. ADA News, CDT is ADA intellectual property; ADA, licensing for commercial users.
  5. Stedi, Differences between 837P, 837D, and 837I claims; UnitedHealthcare, 837D companion guide (005010X224A2); Delta Dental, 837 companion guide.
  6. DentalXChange, ClaimConnect services; Vyne Dental, payer connectivity; BCBSM, companion guide noting 837D via Availity.
  7. ADA, Dental claim form; 2024 completion instructions (PDF).
  8. Vyne Dental, FastAttach; GEHA, NEA FastAttach payer instructions; Open Dental, claim attachments documentation.
  9. Administrative Simplification: Adoption of Standards for Health Care Claims Attachments Transactions and Electronic Signatures, 91 Fed. Reg. 14350 (Mar. 24, 2026), compliance May 26, 2028. Federal Register; 2022 proposed rule.
  10. ADA, D9995/D9996 teledentistry guide (PDF).
Last modified on August 21, 2026