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Editing treatment

After treatment has been entered into the Patient Chart, you can make changes to the procedure as needed, as long as the procedure is not in history or as long as a certain global setting (which prohibits edits from being made immediately after posting or after a specified length of time has passed) has not been enabled.

Also, if the completing provider override feature is enabled, you cannot change the provider attached to a treatment-planned procedure after it has been posted. To have the correct provider attached to a treatment-planned procedure, make sure the appropriate provider is displayed on the Patient Chart title bar, or select a different charting session provider before you chart that treatment-planned procedure.

To edit treatment

1.   With a patient selected in the Patient Chart, from the Progress Notes panel, double-click the treatment item that you want to change.

Tip: If the procedure that you want to edit has been posted but is not listed on the Progress Notes panel, verify that the correct status view option has been selected for the progress notes.

The Edit or Delete Procedure dialog box appears.

Tip: If the procedure is treatment planned and its description is a hyperlink, you can click the link to visit one or more website addresses that contain educational videos regarding this procedure.

2.   Make any necessary changes:

·        Date - Type the correct date of the procedure.

Note: You must have the appropriate security right enabled to back date a procedure to a date in a month that has been closed.

·        Clinic - To change the clinic, click the Clinic search button to select the correct clinic.

·        Encounter # - This option is available only if you enabled a certain global setting. If the field is available, type an encounter number (numeric or alphanumeric, depending on a certain global setting), or click the search button to select it (if the appropriate global setting is enabled). Also, depending upon a certain global setting, the number may have to be unique for each patient, for each day, or for each patient per day.

·        Procedure - To change the procedure, click the Procedure search button to select the correct procedure code.

Tips:

·        If you know the correct procedure code, you can just type it in the Procedure field.

·        The description for the specified procedure appears to the right of the Procedure field.

·        Tooth - If applicable, enter the correct tooth number or letter (or supernumerary tooth number or letter).

·        Other treatment areas - Do one of the following if applicable:

·        For a surface, click the Surface search button to select the correct surface.

·        For a quadrant, click the Quadrant search button to select the correct quadrant.

·        For an arch, click the Arch search button to select the correct arch.

·        For an sextant, click the Sextant search button to select the correct sextant.

·        Amount - Type the correct amount charged for the procedure. To change the amount you must have the "Fee Amount, Edit" security right enabled for your user account.

·        RVU - Type the correct RVU for the procedure.

·        Override Ins. estimate - If the patient has primary and/or secondary dental insurance coverage, the corresponding options are available to allow you to override what Dentrix Enterprise has estimated will be the insurance portion of the charges for the procedure. Select the appropriate check boxes, and then type the correct amount.

·        Do Not Bill Dental Insurance - If the patient has dental insurance coverage, this option is available. If you do not want to create a claim for the procedure, select this option. An "X" will appear in the Ins column for the procedure in the patient's Ledger to indicate that the insurance carrier will not billed for the procedure.

·        Provider - To change the provider attached to the procedure, click the Provider search button to select the correct provider.

·        Require Start/Completion Date - If the procedure requires a start and completion date, the Require Start/Completion Date check box is selected by default, and the current system date appears in the Start Date and Completion Date fields. To override the requirement this time for the procedure, clear the check box. If the procedure does not require start and completion dates, but you want to require them this time, select the check box, and then leave the current system date in the fields or change them as needed.

Notes:

·        If you select Require Start/Completion Date, you must enter a Start Date.

·        The start and completion dates are used for submitting claims electronically.

·        Modifier - To add a modifier (one or two alphanumeric characters) to the end of the procedure code, enter it.

·        Notes - Make any necessary changes to the note, and specify the reason for the procedure needing to be changed (for auditing purposes). 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).

·        Procedure Status - To change the procedure status, select the correct status.

·        Approval Status - With Treatment Plan selected under Procedure Status, you can select an Approval Status.

Notes:

·        You cannot change the approval status once a claim has been created for the procedure or if your Dentrix Enterprise user account does not have the "Approval Status" security right option enabled.

·        When a procedure is completed, the last approval status selected before the procedure was set complete remains selected and appears next to the procedure in the AP column in the Ledger, Ledger-Treatment Plan, and Patient Chart.

·        You can define statuses from the Practice Definitions.

3.   To link the procedure to or unlink the procedure from conditions, do the following:

a.   Click the Conditions search button .

The Select Condition Codes dialog box appears.

b.   Select the check box of any condition (or Dental Diagnostic Code) that you want the procedure to be linked to. Clear the check box of any condition that you no longer want the procedure to be linked to. To clear the check boxes of all the conditions listed, click Clear Selection.

c.   Click OK.

d.   Select an Invalidate Upon Completion option to specify how you want to handle the invalidation of the conditions that the procedure is linked to when you complete the procedure (if it has been treatment-planned):

·        None - The conditions that the procedure is linked to will not be invalidated.

·        Automatic - The conditions that the procedure is linked to will be invalidated automatically.

·        With Verification - You will choose which conditions you want to invalidate.

Note: A certain clinic setting determines the default selection under Invalidate Upon Completion.

4.   To add diagnostic codes (ICD-9-CM, ICD-10-CM, and/or Dental Diagnostic Codes) to a procedure, do the following:

Note: You cannot attach diagnostic codes to conditions, clinical notes, exams, or referrals.

a.   Click the Diagnoses search button .

The Select Diagnostic Codes for Dental Claims dialog box appears.

Note: In the upper-left corner, the patient's insurance plans appear in the boxes that corresponds to the diagnostic coding system that claims that are sent to those carriers will use: ICD-9, ICD-10, or Unspecified (none). This is determined by a certain setting for each dental and medical insurance plan.

b.   Do any of the following:

To add ICD-9-CM codes

i.     Select ICD 9 to view the diagnostic codes that have been cross coded with the procedure. You can also type all or part of a code or description in the Search field to further filter the list to include only the codes that match what you have entered.

Note: If the ICD-9-CM diagnostic code that you are looking for is not listed, select List all codes to select the code from a list of all the ICD-9-CM diagnostic codes.

ii.    Select the ICD-9-CM codes that you want to add (to select multiple codes that are not adjacent to each other, hold down the Ctrl key, and then click each code; or to select a range of adjacent codes, hold down the Shift key, and then click the first and last code in the range).

iii.   Click Add to move the codes to the ICD-9-CM Codes Applied list box. You can attach up to four ICD-9-CM codes to any given procedure. The Add button is available only if the number of ICD-9-CM codes that you have selected (in the left list box) and the number of ICD-9-CM codes that are already attached to the procedure (in the ICD-9-CM Codes Applied list box) is less than or equal to four and if the number of ICD-9-CM codes that you have selected (in the left list box) and the total number of codes that are already attached to the procedure (the combined total from the ICD-10 Codes Applied, ICD-9 Codes Applied, and Other Dental Diagnostic Codes Applied list boxes) is less than or equal to eight.

Note: To remove specific ICD-9-CM codes from the procedure, select those codes in the ICD-9-CM Codes Applied list box, and then click Remove. To remove all ICD-9-CM codes from the procedure, click Clear next to the ICD-9-CM Codes Applied list box.

To add ICD-10-CM codes

i.     Select ICD 10 to view the diagnostic codes that have been cross coded with the procedure. You can also type all or part of a code or description in the Search field to further filter the list to include only the codes that match what you have entered.

Note: If the ICD-10-CM diagnostic code that you are looking for is not listed, select List all codes to select the code from a list of all the ICD-10-CM diagnostic codes.

ii.    Select the ICD-10-CM codes that you want to add (to select multiple codes that are not adjacent to each other, hold down the Ctrl key, and then click each code; or to select a range of adjacent codes, hold down the Shift key, and then click the first and last code in the range).

iii.   Click Add to move the codes to the ICD-10-CM Codes Applied list box. You can attach up to four ICD-10-CM codes to any given procedure. The Add button is available only if the number of ICD-10-CM codes that you have selected (in the left list box) and the number of ICD-10-CM codes that are already attached to the procedure (in the ICD-10-CM Codes Applied list box) is less than or equal to four and if the number of ICD-10-CM codes that you have selected (in the left list box) and the total number of codes that are already attached to the procedure (the combined total from the ICD-10 Codes Applied, ICD-9 Codes Applied, and Other Dental Diagnostic Codes Applied list boxes) is less than or equal to eight.

Note: To remove specific ICD-10-CM codes from the procedure, select those codes in the ICD-10-CM Codes Applied list box, and then click Remove. To remove all ICD-10-CM codes from the procedure, click Clear next to the ICD-10-CM Codes Applied list box.

To add Dental Diagnostic Codes

i.     Select Dental Diagnostic to view the diagnostic codes that have been cross coded with the procedure.

Note: If the Dental Diagnostic Code that you want to add is not listed, select List all codes to select the code from a list of all the Dental Diagnostic Codes.

ii.    Select the Dental Diagnostic Codes that you want to add (to select multiple codes that are not adjacent to each other, hold down the Ctrl key, and then click each code; or to select a range of adjacent codes, hold down the Shift key, and then click the first and last code in the range).

iii.   Click Add to move the codes to the Other Dental Diagnostic Codes Applied list box. You can attach up to four Dental Diagnostic Codes to any given procedure. The Add button is available only if the number of Dental Diagnostic Codes that you have selected (in the left list box) and the number of Dental Diagnostic Codes that are already attached to the procedure (in the Other Dental Diagnostic Codes Applied list box) is less than or equal to four and if the number of Dental Diagnostic Codes that you have selected (in the left list box) and the total number of codes that are already attached to the procedure (the combined total from the ICD-10 Codes Applied, ICD-9 Codes Applied, and Other Dental Diagnostic Codes Applied list boxes) is less than or equal to eight.

Note: To remove specific Dental Diagnostic Codes from the procedure, select those codes in the Other Dental Diagnostic Codes Applied list box, and then click Remove. To remove all Dental Diagnostic Codes from the procedure, click Clear next to the Other Dental Diagnostic Codes Applied list box.

c.   Then, with the correct codes added, click OK.

Note: If you attempt to create a claim with more than four distinct diagnostic codes between all the procedures on that claim, a message will appear. You can click OK to have Dentrix create separate claims so that no claim has more than four dental diagnostic codes on it or click Cancel to not create a claim.

Tip: You can also attach diagnoses to multiple procedures at once. Select the appropriate completed and/or treatment-planned procedures on the Progress Notes panel of the Patient Chart, and then, from the Dental Diagnostics menu, click Attach to Selected Procedure(s).

5.   If the procedure has been set up to be for an implantable device, to attach an implantable device, do the following:

a.   Click the Implant Device search button .

The New Patient Medical Alert(s) dialog box appears.

b.   Set up the following options:

·        UDI - Click Add UDI to search for the implantable device in the public, online Global Unique Device Identification Database (GUDID), which is maintained by the Food and Drug Administration (FDA). Alternatively, Dentrix Enterprise can insert the UDI if you scan the device's barcode with a barcode scanner.

Note: You do not change any of the other options in the New Patient Medical Alerts(s) dialog box that are already populated with data from the GUDID if the device is found.

·        Description - Leave the default description, or enter a brief description of the device as you want it to appear in the Medical Alerts dialog box.  

·        Discovery Date - Enter the date that you found out about the device. By default, the current date is entered.

·        Area - Enter the area where the device is implanted.

·        GMDN PT Name - If known, enter the Global Medical Device Nomenclature (GMDN) Preferred Term (PT) name of the device.

·        Lot/Batch - If known, enter the lot or batch number of the device.

·        Serial # - If known, enter the serial number of the device.

·        Distinct ID - If known, enter the catalog reference number of the device.

·        Expiration Date - If known, enter the expiration date of the device.

·        Manufacturing Date - If known, enter the date that the device was made.

·        Device Attributes:

·        Brand - If known, enter the brand name of the device.

·        Version/Model # - If known, enter the version or model number of the device.

·        Company - If known, enter the name of the company who made the device.

·        MRI Safety Status - If known, enter the safety rating of the device for use in or near a Magnetic Resonance Imaging (MRI) environment.

·        Labeled as containing NRL - If known, select or clear the check box to indicate if the device is labeled as containing natural rubber latex (NRL).

·        Notes - Enter any notes regarding the implantable device. You can click the Check Spelling button (this button is available only if a certain preference setting has been enabled) to check the spelling of the note.

c.   Click OK.

The description specified appears in the box.

6.   To view any credits that have been allocated to the procedure, click Credits.

7.   You can enter a related referral (inbound or outbound) for this procedure.

8.   Click OK.

Changes to completed procedures are stored in Dentrix Enterprise. You can generate an audit trail report to see the original entry along with the change.