Hi Guest!

To indicate maxillary arch only for a service, you would use: JO01
For mandibular arch for a service: JO02

For both arches for a service: JO01 02

If you are only identifying the upper left quadrant (maxillary) and lower right quadrant (mandibular), then yes it would be: JO20 40


You can see examples of this in the CMS1500 claim form manual. Here is a link to the current manual, and you will find the tooth number and areas of oral cavity examples of page 48:

https://www.nucc.org/images/stories/PDF/1500_claim_form_instruction_manual_2019_07-v7.pdf

Hope this helps!

Hi Guest!

Great question. That would be entered into the red shaded line of the line item (service) in box 24, for "supplement information".

Examples of how this would look on the medical claim can be found in the NUCC's CMS 1500 claim form manual here, starting on page 46, examples shown on page 47:
http://www.nucc.org/images/stories/PDF/1500_claim_form_instruction_manual_2012_02-v4.pdf


If you are a DentalWriter software client, here are instructions to use the JO/JP qualifiers in your DentalWriter software below:

1) In any claim in DentalWriter, double click on any line item in box 24 (or click in any white box in the line item then click the "edit service" button at the bottom of box 24) in which you wish to add the qualifiers.

2) A "procedure or service" window will appear where you can edit information on that line item. Scroll to the bottom of that window to the "supplemental information" field and type in your desired qualifier with the tooth number(s) or area of the oral cavity codes defined above, then click the "save and close" button in the upper left hand corner of the window, shown below:

3) The text you entered will appear in the red shaded line above the dates of service of the line item you selected

Hope this helps!

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