INSIDE BACK COVER OF DENTAL
On this page of the dental record jacket, place all
forms listed below in the order given.
Record Identifier for Personnel Reliability
Program, NAVPERS 5510/1 (if applicable).
Current Status Form.
Reserve Dental Assessment and Certification
Form, NAVMED 6600/12 (if applicable).
Most current Dental Treatment Form, EZ603A.
Previous Dental Treatment Forms (EZ603As,
Old SF603s and 603As) in reverse
Consultation Sheet, SF 513 (when related to
Narrative Summary, SF 502 (when related to
Doctors Progress Notes, SF 509 (when related
to dental treatment).
Tissue Examination, SF 515 (if required).
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
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
Pertinent health care information, necessary to
document treatment, but not available on authorized
forms as listed above, may be filed in the treatment
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.
MAINTENANCE OF THE DENTAL
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
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
Terminal Digit Filing System
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 sections primary number.
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