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Adding and editing ADA-CDT dental codes

You can add and edit the procedure codes you post in your practice.

To add or edit dental codes

1.   While logged in to the Central clinic, in the Office Manager, from the Maintenance menu, point to Practice Setup, and then click Procedure Code Setup.

The Procedure Code Setup dialog box appears. The ADA-CDT Codes tab is selected by default.

2.   Select a category in the Procedure Code Category list box.

All procedure codes associated with that category appear in the list box to the right.

3.   Do one of the following:

·        To add a new procedure code, click New. The Procedure Code Editor - New dialog box appears.

·        To edit an existing procedure code, select that procedure code, and then click Edit. The Procedure Code Editor - Existing dialog box appears.

4.   Enter or change the following procedure information:

·        Description - The description for this procedure is displayed in most of the Dentrix Enterprise modules and on insurance claims, billing statements, and various reports. The ADA description is included for each Dentrix Enterprise procedure and abbreviated as necessary.

·        Patient Friendly Description - When this code is shown in the Treatment Planner, instead of displaying the technical description for the procedure, a less-technical description can be displayed, so patients may better understand the procedures in their treatment plans. Any changes made to a procedure's patient-friendly description here will be reflected in the case details of the Treatment Planner the next time the Treatment Planner window is opened.

·        ADA Code - The standard ADA code is displayed for the procedure in most of the Dentrix Enterprise modules. It is also used to print some reports by procedure range. (All ADA codes are included with Dentrix Enterprise when the program is first installed.)

Tip: If you want to create a custom procedure code (for instance, to create a claim using a rate code) that is based on the ADA code, you can add a period (.) and up to three numbers and/or digits after the period (for example, "D0120.a"). The period and anything after it will not appear on the claim.

·        Abbrev Desc - The abbreviated description is displayed in the Appointment Book as the description when a procedure is scheduled. (The abbreviated description is included with Dentrix Enterprise when the program is first installed.)

·        Alternate codes - Any of the three alternate codes can be used when insurance companies do not accept the standard ADA code: CPT, Medicaid, and Code 5. The names of these fields can be changed in Practice Definitions. Alternate codes can be printed on insurance claims for carriers that require alternate codes.

·        Treatment Flags - Select the appropriate treatment flags for the procedure to indicate how the procedure will be handled in certain situations:

·        Difficult Proc - This flag can help you create a quick, end-of-day call lists. An asterisk (*) will appear next the phone number of a patient on the day sheet if that patient has a posted procedure that has been flagged as difficult. Certain procedure codes come with this flag pre-selected when Dentrix Enterprise is first installed.

·        Condition - With this flag, you can use procedure codes to indicate the state of a patient's mouth. You can post a condition in the Patient Chart but not in the Ledger, and no fee is associated with a condition. Dentrix Enterprise has already flagged procedures 15000 - 15115 as Conditions. Other Conditions can be added as needed.

·        Remove Tooth - When a procedure with this flag is posted as complete in the Patient Chart, the selected tooth for the procedure is removed from the graphical chart. The applicable Dentrix Enterprise procedures, such as extractions and missing teeth, already have this flag when Dentrix Enterprise is first installed.

As you click this option, the check box will alternate between being selected, cleared, and selected but grayed out. A grayed-out check mark is used internally within Dentrix Enterprise, and you cannot assign this status manually to a procedure code. The check box must be either selected or cleared to save your changes.

·        Show in Chart - If this procedure is a commonly used procedure in your office, select this option. The procedure will be listed for the corresponding procedure code category button in the Patient Chart.

Tip: Once the Show in Chart check box is selected or cleared, and the procedure code is saved, you must close and re-open the Patient Chart so that the procedure is listed for or removed from the corresponding category button.

·        Auto Continuing Care - With a continuing care type attached to a procedure that is scheduled or treatment-planned for a patient, Dentrix Enterprise automatically updates that patient's continuing care due date by the interval assigned to the selected continuing care type when the procedure is completed. If the patient has not yet been assigned the selected continuing care type, the continuing care type is assigned to the patient.

To attach a continuing care type to the procedure, complete the following steps:

a.   Click the Auto Continuing Care search button .

The Select Continuing Care Type dialog box appears.

b.   Select the appropriate continuing care type. Any given procedure code can only have one continuing care type assigned to it, but a continuing care type can be assigned to any number of procedures.

c.   Click Select to assign the selected continuing care type.

·        Procedure Time - You can set the number of Appointment Book units this procedure takes to perform to help you when scheduling appointments:

a.   Click the Procedure Time search button .

The Appointment Time Pattern dialog box appears.

b.   Drag the slider to set the amount of time needed to complete the procedure. The time is displayed in units. (One unit is equal to the time block size you chose when setting up the clinic in the Appointment Book.) Clicking the right arrow will add a unit, and clicking the left arrow will subtract a unit.

c.   The box below each unit defaults to an X. Click the box to change what appears inside it. The status of the box represents who is providing care to the patient during the procedure:

An X represents the provider's time.

A single slash represents the assistant's time.

Clear represents chair time.

These assignments can be used while scheduling appointments and can help you to maximize your productivity and the use of all operatories.

d.   Click OK to save the time pattern.

·        Procedure Code Category - Select the appropriate category for this procedure code. In Practice Definitions, you can customize the procedure categories to fit your practice's needs. If you want this procedure to show in the Patient Chart for the category you have selected, you must also select Show in Chart under Treatment Flags.

Tip: Since you cannot delete a procedure code, if you do not want to use a certain procedure code, change the Procedure Code Category to "[None]."

·        Appointment Type - Select an appointment type. By giving each procedure a specific appointment type, you can schedule your work to meet daily and weekly goals and keep your office flowing smoothly.

Dentrix Enterprise comes installed with the following four appointment types: General, High Production, Medium Production, and Low Production. Appointment types can be set up in Practice Definitions.

·        Treatment Area - Select a treatment area. The treatment area is used to indicate the area of the mouth to which this procedure applies. The treatment area can flag a specific area when a procedure is charted:

·        Surface, Tooth, and Root flag a tooth

·        Surface flags one surface

·        Mouth does not flag anything, except possibly a tooth range

·        Quadrant, Sextant, and Arch flag a selected area of the mouth (for example, the upper-left quadrant).

The applicable treatment area is applied to each procedure that is included with Dentrix Enterprise when first installed.

You can have Dentrix Enterprise automatically correct the procedure code when posting or changing the procedure, according to the tooth number and surfaces selected. (These flags to change the procedure code can be overridden when posting or editing procedures.) To set the flags for the selected treatment area, click Flags. The name of the dialog box that appears varies, depending on the selected Treatment Area. The following is an explanation of the flags for each treatment area:

·        Root - When the treatment area is Root, the Root Flags dialog box appears. Type the procedure code that is to be used relative to the number of roots a selected tooth has when this procedure is charted for the patient.

·        Surface - When the treatment area is Surface, the Surface Flags dialog box appears. Type the procedure code that is to be used relative to the number of surfaces entered when this procedure is charted for the patient.

Under Dentition/Position Flags, you can type the procedure code relative to the dentition and position (Primary, Permanent, Anterior, Posterior) that will be posted.

·        Tooth - When the treatment area is Tooth, the Tooth Flags dialog box appears. Type the procedure code that is to be used for all but the first entry when this procedure is charted complete.

Under Dentition/Position Flags, you can type the procedure code relative to the dentition and position (Primary, Permanent, Anterior, Posterior) that will be posted.

·        Arch - When the treatment area is Arch, the Arch Flags dialog box appears. Type the procedure codes for alternate arches.

·        Mouth - When the treatment area is Mouth, the Mouth Flags dialog box appears. The Use Selected Teeth for Range option requires a tooth range when this procedure is charted or posted for a patient. The Use Default Teeth for Range option is for procedures, such as dentures. The options under Arch Flags are only available if Use Selected Teeth for Range is selected.

·        Paint Type - Select the paint type that indicates how the procedure will be painted on the tooth on the graphical chart in the Patient Chart when the procedure is charted for a patient. The procedures included with the initial install of Dentrix Enterprise have the applicable paint types, which can be set up in Practice Definitions.

·        Notes - A procedure can have a progress note and a recommendation note. You can add or change the notes at any time:

a.   Click Edit Note.

The Edit Procedure Code Notes dialog box appears.

b.   Type a progress note under Procedure Code Progress Note. Procedure Code Progress Notes can also be added for conditions. No Procedure Code Notes are included with any of the procedures included with the initial install of Dentrix Enterprise.

Also, you can click the Check Spelling button to check the spelling of the note text (this button is available only if a certain preference setting has been enabled).

You must type a note to activate the options below the field.

The progress note you type will be used according to the selected When this procedure is set complete option:

·        Copy To Procedure Note - When this option is marked, whenever the procedure is completed for a patient, the procedure code progress note entered will be automatically added to the note for the patient's procedure.

·        Copy to Clinical Note - When this option is marked, the procedure code progress note entered will be automatically added to the Clinical Note for the patient whenever the procedure is completed.

·        Do Not Copy - When this option is marked, it will not change the note in any way, but the procedure code progress note will not be automatically copied to a procedure that is completed.

c.   Type a Recommendation Note. Also, you can click the Check Spelling button to check the spelling of the note text (this button is available only if a certain preference setting has been enabled).

If Print Note on Walkout is selected, when you print a walkout statement (a family walkout and doctor's statement) from the Ledger and choose to print doctor recommendations, the recommendation note for this procedures when it appears on the walkout will be printed, as well. On walkouts, the recommendation notes appear only once if the same procedure is printed more than once on the walkout.

d.   If you want to attach a documents, place the text cursor at the end of the recommendation note, click the Recommendation Documents search button to open the Recommendation Documents dialog box, select the documents you want to attach, and then click OK.

Each recommendation document name is enclosed in double arrows (<< >>) in the Recommendations Note field. For example, if the document "crown.doc" is selected as a recommendation document, <<crown.doc>> will be displayed at the end of the procedure's recommendation note. Recommendation documents are Microsoft Word documents that are located in the Docs directory where the Dentrix Enterprise program files are installed (the default installation path is C:\Program Files\DXOne\Docs). Recommendation documents cannot be merge letters.

e.   Click OK to save the notes.

·        Fee Schedule - You can assign up to 99,999 fees for each procedure. With fee schedules, you have the flexibility to pre-set alternative fees for certain patients, such as family members, special insurance holders, and senior citizens.

When a procedure is entered in the Ledger or Patient Chart, the charge is assigned according to the selected provider's fee schedule. You can also choose to override the provider's fee schedule by assigning a fee schedule to a patient or to an insurance carrier.

Note: It is recommended that you add the practice's usual, reasonable, and customary (UCR) fees to the first fee schedule.

No fees are pre-assigned with the initial install of Dentrix Enterprise. To add or change the fees for a procedure, complete the following steps:

a.   Select the fee schedule to which you want to assign a fee.

b.   Click Edit Fee.

The fee appears in a field next to the name of the fee schedule and can be edited.

c.   Type the dollar amount you want to charge.

d.   Press ENTER on your keyboard to save the change or press TAB to move down to the next fee schedule.

e.   Repeat steps a - d for all fees you wan to add or change.

Note: Any changes to fee schedules that you make here are reflected in the Fee Schedule Setup dialog box.

·        RVU Schedule - Relative Value Units (RVU) are a comparable service measure of the amounts of resources required to perform various services (in other words, a value assigned to a procedure that places a worth on the amount of time that it takes to do a procedure) and are generally used to track provider production and for the payment of providers.

Notes:

·        The RVU is decided per clinic. There are not RVU guidelines like there are for recommended fees for each geographical location.

·        The RVU can also be assigned to codes that have a charge. Then, the clinic may have a goal for total RVU’s that a provider should be meeting on a daily basis, instead of a production goal. This is especially true in a clinic that doesn’t pay providers based on production or collections.

When a procedure is entered in the Ledger or Patient Chart, the RVU is assigned according to the selected provider's RVU schedule. You can also choose to override the provider's RVU schedule by assigning an RVU schedule to an insurance carrier.

No RVU amounts are pre-assigned with the initial install of Dentrix Enterprise. To add or change the RVU amounts for a procedure, complete the following steps:

a.   Click the RVU Schedule tab.

b.   Select the RVU schedule to which you want to assign an amount.

c.   Click Edit RVU.

The amount appears in a field next to the name of the fee schedule and can be edited.

d.   Type a dollar amount.

e.   Press ENTER on your keyboard to save the change or press TAB to move down to the next RVU schedule.

f.   Repeat steps b - e for all amounts you want to add or change.

·        If applicable, type a lab expense for this procedure in the Lab field. The lab expense will print on the Fee Schedule Report and RVU Schedule Report. No lab expenses are included for the procedures included with the initial install of Dentrix Enterprise, and it is recommended that they be added during the initial setup if you want to include lab expenses.

·        If applicable, type a materials expense for this procedure in the Materials field. The materials expense will print on the Fee Schedule Report and RVU Schedule Report. No material expenses are included for the procedures included with the initial install of Dentrix Enterprise, and it is recommended that they be added during the initial setup if you want to include material expenses.

·        Flag for Medical Cross Coding - If you want to bill medical insurance any time this procedure is used, select the check box.

Important: You can only bill medical insurance for procedures with Flag for Medical Cross Coding selected.

Tip: For information about medical cross coding, refer to the topics about adding, editing, and deleting medical codes and medical cross coding.

·        Do Not Bill Dental Insurance - If you want to prevent claims from being created for this procedure from the Ledger or when creating a batch of primary dental insurance claims from the Office Manager, select the check box. This option also prevents this procedure code from appearing on the Procedures Not Attached To Insurance Report.

·        Do Not Send Over HL7 - If you do not want this procedure to be sent to your medical practice management software through the HL7 interface, select the check box. The availability of this check box is determined by a global setting.

·        Require Start/Completion Dates - If you want to require that a start date and a completion date be entered when posting this procedure, select this check box. The start and completion dates are used to fulfill a HIPAA requirement for submitting claims electronically.

·        Implantable Device - If this procedure is for an implantable device, select the check box.

·        Eclaims: Require attachment - If this procedure requires an attachment for electronic claims, select the check box.

·        Educational Video - Click this button to link one or more website addresses that contain educational videos to this procedure.

5.   Click Save.