![]() The form includes box 34 for the diagnosis code list qualifier that indicates which diagnostic coding system was used (for example, ICD-9), box 34a for listing diagnosis codes, and box 29a for the diagnosis code pointer that associates procedures on the claim form with their corresponding diagnosis code(s). The 2012 ADA Dental Claim Form (J430) is now available inside of Dentrix for customers running Dentrix G4 Productivity Pack 8 or later.ĪDA Claim Form J430 supports reporting up to four diagnosis codes per claim. ![]() Get the support you need the way you want it
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