Box 59

Examination and treatment plan: Use the American Dental Association's Current Dental Terminology (CDT-3) for appropriate procedure codes. If a procedure is performed multiple times, record the Procedure Code once and the frequency in the quantity (Qty) column. When completing the Diagnosis Index # column, enter the index # (1-8) for as many diagnoses as necessary for each Procedure Code. When a patient has more than one diagnosis per procedure, separate index number with comma.

This information comes from the Charge Detail screen.