| March 2024
Dear Dental Healthcare Provider
Mouthpart abbreviation codes for claims
We appreciate your support to the valued members of the medical schemes under our administration. Furthermore, we would like to thank you for including the corresponding tooth numbers when submitting claims. By supplying this information, we are able to process your claims faster and more efficiently.
We would therefore like to do the same with dentures and other claims involving parts of the mouth, and not just for singular teeth. Our system has been developed to accept the International Standards Organisation (ISO) abbreviations for identification of the mouthpart. This includes the arch, sextants or quadrant, which will help us identify whether a denture is, for example, for the top or bottom jaw, without needing to reject the claim or requesting further information.
What does this mean for you?
By including the two-digit mouthpart code when submitting the claim, we will be able to process it immediately without any hassles. Currently, these claims are being rejected, which leads to frustration and additional work on your part and you may need to submit a motivation. The mouthpart is essential for us to match the claim with the applicable medical scheme rules.
ISO abbreviation codes for the various mouthparts (similar to the tooth number)
ISO abbreviation
code |
Area of the mouth (mouthpart) |
| 00 |
The complete oral cavity |
| 01 |
The maxilla |
| 02 |
The mandible |
| 03 |
Upper-right sextant (teeth 14 – 18 or 54 – 55) |
| 04 |
Upper-anterior sextant (teeth 13 – 23 or 53 – 63) |
| 05 |
Upper-left sextant (teeth 24 – 28 or 64 – 65) |
| 06 |
Lower-left sextant (teeth 34 – 38 or 74 – 75) |
| 07 |
Lower-anterior sextant (teeth 33 – 43 or 73 – 83) |
| 08 |
Lower-right sextant (teeth 44 – 48 or 84 – 85) |
| 10 |
Upper-right quadrant |
| 20 |
Upper-left quadrant |
| 30 |
Lower-left quadrant |
| 40 |
Lower-right quadrant |
Basic scenarios to clarify what must be included in your claims:
| Scenario |
Procedure code |
Code to identify for area
of mouth (mouthpart) |
| New upper partial denture with clasps |
8255 |
01 |
| Bone regeneration done with periodontal surgery for teeth 32 and 36 |
8766 |
30 |
| New complete lower denture |
8232 |
02 |
| New full upper denture and re-line on existing lower denture |
8232 |
01 |
| 8267 |
02 |
| Root planing on teeth 44 and 46 |
8739 |
40 |
| Gingivectomy on teeth 11, 12, 13, 21, 22 and 23 |
8743 |
10 |
| 8743 |
20 |
| Root planing on teeth 31, 32, 33, 34 and 41 |
8737 |
30 |
| 8739 |
40 |
| Provisional splinting wire with resin of teeth 11, 12, 21 and 22 |
8725 |
04 |
We kindly request your support in this initiative and that you endeavour to submit all claims with the appropriate abbreviation codes with effect from 1 May 2024. This will most certainly reduce any unnecessary administrative burden on your practice.
Should you have any queries in this regard, please do not hesitate to contact the relevant client service team below:
Kind regards
Provider Management
Momentum Health Solutions |
