Resource Center

Documentation Requirements

This list is intended to be used as a guide in the submission of electronic attachments. This does not preclude WDS from requesting additional documentation when necessary.

Procedure 
Code
Documentation
Reqiurement
Procedure 
Code
Documentation
Reqiurement
Procedure 
Code
Documentation
Reqiurement
D0472 Pathology report  D4210 Perio chart 1 D7288 Pathology rpt
D0473 Pathology rpt D4211 Perio chart 1 D7411 Pathology rpt
D0474 Pathology rpt D4240 Perio chart 1 D7412 Pathology rpt
D0475 Pathology rpt D4241 Perio chart 1 D7413 Pathology rpt
D0476 Pathology rpt D4245 Perio chart 1 D7414 Pathology rpt
D0477 Pathology rpt D4249 X-ray and narrative D7415 Pathology rpt
D0478 Pathology rpt D4260 Perio chart 1 D7440 Pathology rpt
D0479 Pathology rpt D4261 Perio chart 1 D7441 Pathology rpt
D0480 Pathology rpt D4274 Perio chart 1 D7450 Pathology rpt
D0481 Pathology rpt D4381 Perio chart 1 D7451 Pathology rpt
D0482 Pathology rpt D4999 Narrative D7460 Pathology rpt
D0483 Pathology rpt D5899 Narrative D7461 Pathology rpt
D0486 Pathology rpt D5999 Narrative D7465 Pathology rpt
D0502 Pathology rpt D6199 Narrative D7999 Narrative
D0999 Narrative D6973 X-ray and narrative D8999 Narrative
D2799 Pathology rpt D6999 Narrative D9930 Narrative
D2950 X-ray and narrative D7241 X-ray and narrative D9940 Case Type 2
D2962 X-ray and narrative D7251 X-ray and narrative D9951 Tooth numbers adjusted
D2999 Narrative D7285 Pathology rpt D9999 Narrative
D3999 Narrative D7286 Pathology rpt

1 Perio chart must be no more than 12 months old on the date of service.
2 Only if the group covers occulsal guards for perio only

For claims requiring attachments, Washington Dental Service accepts electronic attachments through FastAttach, offered by National Electronic Attachments (NEA). This means you can submit scanned x-rays, intra-oral photographs, periodontal charts and more when providing supporting clinical documentation for electronic claims. Using electronic attachments can not only accelerate claim processing, but will also eliminate the need and cost to duplicate and mail x-rays and other necessary attachments.

Here's what you will need to utilize FastAttach:
•  Pentium processor computer or equivalent
•  Monitor with video card capable of 24-bit color
•  An internet service provider
•  Windows 98, Windows NT 4.0 or higher
•  Microsoft Internet Explorer 4.0 or higher
•  A way to digitize your attachments (a scanner or digital x-ray system)

For more information about NEA FastAttach, please visit www.nea-fast.com or call (800) 782-5150.

Questions? Call Washington Dental Customer Service at (800) 554-1907, Monday through Friday, between 8 am and 5 pm, PT.