CSHCN 2008 >13.5.2 Supernumerary Tooth Identification

13.5.2 Supernumerary Tooth Identification

Each identified permanent tooth and each identified primary tooth has its own identifiable supernumerary number. This developed system can be found in the 2007-2008 CDT published by the ADA.

The TID for each identified supernumerary tooth is used for paper and electronic claims and can only be billed with the following codes:

•For primary teeth only: D7111.

•For both primary and permanent teeth the following codes are billable: D7140, D7210, D7220, D7230, D7240, D7241, D7250, D7285, D7286, and D7510


Permanent Teeth Upper Arch
Tooth #	1	2	3	4	5	6	7	8	9	10	11	12	13	14	15	16
Super #	51	52	53	54	55	56	57	58	59	60	61	62	63	64	65	66


Permanent Teeth Lower Arch
Tooth #	32	31	30	29	28	27	26	25	24	23	22	21	20	19	18	17
Super #	82	81	80	79	78	77	76	75	74	73	72	71	70	69	68	67


Primary Teeth Upper Arch
Tooth #	A	B	C	D	E	F	G	H	I	J
Super #	AS	BS	CS	DS	ES	FS	GS	HS	IS	JS


Primary Teeth Lower Arch
Tooth #	T	S	R	Q	P	O	N	M	L	K
Super #	TS	SS	RS	QS	PS	OS	NS	MS	LS	KS

Providers billing for dental services may bill electronically or use the ADA Dental Claim Form.

Refer to: Chapter 5.7.1.9, "Instructions for Completing the ADA Dental Claim Form," on page 5-37.