On this page of the dental record jacket, place all dental forms listed below in the order given.
1. Record Identifier for Personnel Reliability Program, NAVPERS 5510/1 (if applicable).
2. Current Status Form.
3. Reserve Dental Assessment and Certification Form, NAVMED 6600/12 (if applicable).
4. Most current Dental Treatment Form, EZ603A.
5. Previous Dental Treatment Forms (EZ603As, Old SF603s and 603As) in reverse chronological order.
6. Consultation Sheet, SF 513 (when related to dental treatment).
7. Narrative Summary, SF 502 (when related to dental treatment).
8. Doctor's Progress Notes, SF 509 (when related to dental treatment).
9. Tissue Examination, SF 515 (if required).
10. Request for the Administration of Anesthesia and for Performance of Operations and Other Procedures, SF 522 (if required).
Under the following conditions, additional dental treatment forms are approved for inclusion in the dental record.
Other health care treatment forms (e.g., Veterans Affairs (VA), Office of Personnel Management (OPM), Compensation Act (CA), Standard Forms (SF), and optional forms (OF), and civilian practitioner forms) not prescribed may be incorporated in the dental record when considered necessary to document care and treatment. The forms shall be filed in the inside back cover of the dental record jacket at the bottom of the last authorized form listed above (e.g., SF 522), numbered forms grouped together with the most recent form placed on top of each previous form.
Pertinent health care information, necessary to document treatment, but not available on authorized forms as listed above, may be filed in the treatment record. When feasible, attach the form to the appropriate approved form (e.g., attach summaries of reports from civilian practitioners to EZ603 or old SF 603) in the proper sequential order.
In the previous section, we discussed the NAVMED 6150/21-30 and the various forms associated with the record. Part of your duties as dental receptionist and Dental Technician are to properly maintain the dental treatment records and know how to file and retrieve them. To accomplish this, you must understand the following:
SSN Number Groups
Terminal Digit Filing System (TDFS)
Internal Chargeout Control
Records review
SSN Number Groups
The nine digits of the SSN are divided into three number groups for ease in reading. This reduces the chance of transposing numbers. For example the SSN 123-45-6789 is visually grouped and read from right to left as follows:
Primary Group | Second Group | Third Group |
89 | 67 | 123-45 |
File dental records by SSN, according to a terminal digit, color-coded, and blocked filing system. Under this system, the central files are divided into approximately 100 equal sections, which are identified by a maximum of 100 file guides bearing the 100 primary numbers, 00 consecutively through 99.
Each of these 100 sections contain all records whose terminal primary digits (last two numbers) correspond to the section's primary number. For example, every record with the SSN ending in 89, is filed in section 89. Within each of these 100 sections, dental records are filed in numerical sequence according to the second group of numbers. For example, SSNs ending with 6789, 5489, and 8889 would be filed in the order 5489, 6789 and 8889. Centralized files having records based upon more than 200 SSNs, or a file of more that 200 records, may need to use the third group of numbers in filing if
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