DN1

Orthodontic Total Months of Treatment

Pos: 145	Max: 1
Detail - Optional
Loop: 2300	Elements: 3

Ref

Id

Element Name

Req

Type

Min/Max

Usage

DN101

380

Quantity
Description: Numeric value of quantity
Industry: Orthodontic Treatment Months Count
Alias: Orthodontic Total Months of Treatment
NSF Reference: FD0-18.0
This data element should be used to report the total months of orthodontic treatment.

O

R

1/15

Situational

DN102

380

Quantity
Description: Numeric value of quantity
Industry: Orthodontic Treatment Months Remaining Count
Alias: Orthodontic Treatment Months Remaining
NSF Reference: FD0-23.0
This data element should be used to report the treatment months remaining for a transfer patient.

O

R

1/15

Situational

DN103

1073

Yes/No Condition or Response Code
Description: Code indicating a Yes or No condition or response
Industry: Question Response
Required to indicate that services reported on the claim are for orthodontic purposes when the DN101 and DN102 are not used.

O

ID

1/1

Situational

Code

Name

Y

Yes

1.

DN101 is the estimated number of treatment months.

2.

DN102 is the number of treatment months remaining.

3.

DN103 is the extra oral traction device indicator. A "Y" value indicates an extra oral traction device; an "N" value indicates no extra oral traction device.

4.

DN104 is the appliance description.

Notes:

1. This segment is required to report the total months of orthodontic treatment (DN101), the treatment months remaining for a transfer patient (DN102) or the indication that services on the claim were performed for orthodontic purposes (DN103).
2. DN101, DN102 or DN103 must be present if reporting this segment.

Example:

DN1*36*27~