The ADA 2024 claim form changes have been published and are effective January 2024. There are two new fields that we are having problems cross walking to the 837D.
Box 39a. Date Last Scaling and Root Plaining Procedure
and
Box 53a. Locum Tenens Treating Dentist Checkbox (to indicate provider is locum tenens)
We understand where to report the NPI of the Locum Tenens provider, but not an indicator that would indicate the provider is a locum tenens. We have reviewed all the DTP segments but cannot find one specific to date of last scaling and root plaining.
Can you please advise where these would be reported in the current 837 and any future versions of the 837D TR3's?
State agency would like to reject encounters that contain providers who are not on their provider master list unless they are flagged as locum tenens. Aside from reporting the locum tenens NPI in the rendering provider loops of the 837, how should submitters indicate that the provider was locum tenens so that the NPI provider master list validation can be bypassed?
State agency would like to reject encounters for certain periodontal CDT's that do not contain a date of last scaling/plaining. Where should this be reported in the 837D transaction?
The current 005010 837D TR3 does not support sending this information.
Future published versions of the 837D will support sending this information; however, they are not mandated for use at this time.