Denticon Setup Guide - Procedure Code Setup

Procedure Code Setup hosts the master list of all available procedure codes to be used across all offices.

• Note: For more information about accessing procedure codes in the office, see the Office Assignment Setup User Guide.

Procedure codes in Denticon are universal, meaning that the way the code is setup will be the same in all offices.

Main

• Description:
  • Options: Free text field
  • If adding a true ADA code, use the description that matches the ADA. For internal codes, use this field to describe what the code is used for.
• Code:
  • Options: Free text field that allows for alpha numeric characters. The code must be 5 to 10 characters long.
  • If adding a new ADA code or medical code, use the true code with the proper prefix if applicable.
  • It is recommended that when creating internal procedure codes to not use unused ADA codes as the ADA may eventually utilize that code.
  • When creating internal codes, the recommendation is to set up a ‘ZCode’, or a code beginning with the letter ‘Z’. Creating ‘ZCodes’ will identify the code easily as an internal code.
• ADA Category:
  • Options: No user-controlled options
  • Based on the code entered, Denticon is programmed to recognize what ADA or Medical category the code belongs in.
  • When creating the code, the ADA Category will be automatically assigned to fit the correct category.
• User Code:
  • Options: Free text area that allows for alpha numeric characters. The code must be 5 to 10 characters long.
  • A short-hand version of a code can be created and entered in as a User Code. This may be useful for offices moving from a previous legacy software that were previously used to entering in a short code.
  • Note: Entry in this section is not common.
• Other Code:
  • Options: Free text area that allows for alpha numeric characters. The code must be 5 to 10 characters long.
  • Similar to the User Code, this field allows for entry of a separate code to be used to search for or utilize the true code.
  • Note: Entry in this section is not common.

• Recall:
  • Options: Number 00 – 60, interval of months, days, weeks or year; option for +1 day
  • If the procedure code is ‘Recallable’, meaning that the patient should be seen for this procedure on a recurring basis, the code can be set up with a default interval for recall.
  • Codes that are set up with a recall interval will be available for tracking in the ‘Recall Due Dates’ section of the Patient Overview.
  • These codes are also available when running recall due reports to help ensure that patients are being seen for their regular visits.
• Procedure Type:
  • Options: Dental or Medical
  • Procedure type identifies whether the procedure code is used for dental or medical.
• Procedure Time:
  • Options: 0-720 minutes
  • Entry here will set the length of time needed when scheduling this procedure. When this procedure code is attached to an appointment, it will update the duration of the appointment to the time set here.
  • There are several criteria to keep in mind when considering setting up Procedure Time:
    • Procedure codes are Universal, meaning if one provider needs 40 minutes for a procedure and another needs 60, only one selection can be made
    • If more than one procedure is attached to an appointment that has Procedure Time added, the minimum appointment length will be the sum total of all procedures attached to the appointment.
    • Denticon’s Best Practice is to leave Procedure Time blank.
• Time Pattern:
  • Options: ‘X’, ‘/’, ‘.’
  • If using doctor/assistant time, the time pattern can be determined in this field.
  • Note that ‘Procedure Time’ must be chosen in order to create the time pattern. The same considerations for using doctor/assistant time can be reviewed above with Procedure Time.
  • Denticon’s Best Practice is to leave Time Pattern blank.
• Scheduler Production Type:
  • Options: Production Types set up in ‘Misc Setup’
  • This option will indicate the desired production type for the procedure code.
  • Note: Attaching this code does not set the production type of the appointment.
• Insurance Category:
  • Options: Insurance categories as defined in Misc Setup
  • The procedure code will take on the benefits of whichever defined category it is applied to within an insurance plan coverage and limitations.
• Insurance Billing Order:
  • Options: Bill to Dental Insurance, Bill to Dental then Medical, Bill to Medical then Dental, Bill to Medical, Do Not bill to Insurance
  • This sets the default billing order of whether or not the claim shall be billed or not, and if so, in what order.
• NHS Treatment Category
  • Options: 91501 – Band 1, 2, 3; 91504 – Band 1 – ER
  • This option is only used outside the United States.
• NHS Clinical Dataset:
  • Options: Fee text area
  • This option is only used outside the United States.
• Default Notes Macro:
  • Options: Search through any created Notes Macro
  • When this procedure code is posted to ledger and the progress note is started, the pre-selected Notes Macro will appear for the user to complete.
  • The note template will appear for each individual procedure code posted. This means that if the procedure code was charged more than one time prior to beginning the note, the Notes Macro template will appear more than once. (example, two 2-surface composite fillings charged out at the same time will result in the Notes Macro appearing twice, once for each code.)
  • Note: This option sets the Notes Macro globally for all locations. Do not use this option if there are more than one Notes Macro template used.
• Show ADA Code and Description while Auto-Generating Progress Notes:
  • Options: Checkbox Yes or No
  • This option goes along with the previous option where the procedure code and description will be included in the note. This selection will only function if there is a default Notes Macro set up.
• Active:
  • Options: Checkbox Yes or No
  • Determines whether or not the procedure code is active or not.
• Dentist Limited:
  • Options: Checkbox Yes or No
  • If a procedure code is set to ‘Dentist Limited’, that means that only a provider that is set up as a dentist can be assigned the provider for the service. For example, D3330 Root Canal for a Molar tooth would be dentist limited but D1110 Prophylaxis – Adult would not be dentist limited because it could be completed by a dental hygienist.
• Taxable:
  • Options: Checkbox Yes or No
  • Select whether or not this code is subject to sales tax.
• Fee Editable:
  • Options: Checkbox Yes or No
  • This will determine whether or not this code can have the fee modified. This is also subject to user permissions. In order for a service to have the fee modified, the procedure code must be marked as ‘Editable’ under procedure code setup AND have the user permission to edit the fee (Transactions – Edit Fee – Ledger | Transactions – Edit Fee – Treatplan)
• Sales Tax Code:
  • Options: Checkbox Yes or No
  • Code D9985 is currently set up as the sales tax procedure code. When added in the Transactions Entry screen, it will calculate the sales tax of any procedure codes that are set to ‘Taxable’ and uses the office’s sales tax percentage established in the office set up.
• Requires Lab:
  • Options: Checkbox for Yes or No
  • If the procedure code requires a lab, this option can be selected.
  • Note: Selecting this option will not create a lab case for an appointment if attached.
• Ortho Procedure:
  • Options: Checkbox for Yes or No
  • For customers utilizing the Ortho Treatment Card, any procedure that would be completed at the visit or something to schedule for the next visit should be identified here as an ortho procedure. Examples of these would be things such as banding, retainer check, deliver aligners, etc.
• Visit Code:
  • Options: Checkbox for Yes or No
  • A visit code is any procedure that would require a patient to visit the office to have the procedure performed. Examples of visit codes would include exams, fillings, and extractions. Non-visit codes may include products such as toothbrushes or bleaching tubes, or a lab fee.
• Ledger Code:
  • Options: Checkbox for Yes or No
  • This field is no longer active.
• A/R Code:
  • Options: Checkbox for Yes or No
  • This field is no longer active.
• Post-Op:
  • Options: Checkbox for Yes or No
  • Denticon has a report that can be generated that will show all patients who received services that should have a post-op appointment created within a certain date range.
• Exempt from Denti-Cal Max:
  • Options: Checkbox for Yes or No
  • The checkbox should be selected if this procedure code should not apply to the Denti-Cal maximum.
  • Note: This option is only for practices located in California who participate with Denti-Cal.
• Lock Default Provider:
  • Options: Checkbox for Yes or No
  • Procedure codes with a locked default provider are unable to be changed from the designated default provider.
• Default Provider:
  • Options: Dropdown menu containing provider names
  • This option corresponds to the previous item for locking default provider. If a service should always be assigned to a particular provider, then that provider should be selected here.
  • If the procedure code does not have the option for ‘Lock Default Provider’ selected but a default provider is chosen, then the provider for the code can be changed.

Charting

The charting tab determines the area of the odontogram where this procedure code will be applied. Only procedure codes that would have a draw type will have the charting area set up.

• Chart Category:
  
  • The chart category determines where on the odontogram a user will click in order to find the procedure code.
• Tooth Area:
  • Options: Existing Tooth, Missing Tooth, Crown, Implant Crown, Surface(s), Root(s)
  • This determines what area of the tooth needs to be selected for the item to be available for charting.

• Draw Chart As:
  • This will determine what draw type will appear on the tooth for the procedure code. Not all procedures will have a draw type.
• Required:
  • Options: None, Requires Tooth #, Requires Quadrant
  • Set whether or not a tooth number or quadrant is required for this procedure code. By selecting one of the options, that tooth number or quadrant will be listed on the claim form.
• Requires 1 or More Teeth:
  • Options: Checkbox for Yes or No
  • This option becomes available when the previous selected for “Required” is set to “Requires Quadrant”.
  • When utilizing the procedure code, Denticon will first ask to choose the appropriate quadrant followed by the associated teeth.
  • Note: This may be used for identifying which teeth go on a partial denture.
• Requires Surface:
  • Options: Checkbox for Yes or No
  • If the procedure code requires surfaces as part of the draw type or for billing, select this option.
• Min. No. of Surf. Reqd / Max. No. of Surf. Reqd:
  • Options: 0, 1, 2, 3, 4, 5
  • For those procedure codes that do require a surface, select the minimum and maximum number of surfaces required.
• Select Tooth Numbers:
  • For procedure codes that are tooth specific, select the applicable teeth which will place restrictions on what area/teeth the code can be applied to.

• Materials:
  • Options: For those services that require a material choice, such as crowns and fillings, a list of possible materials will appear once the tooth/teeth selection has been made. Multiple material choices can be made for each code if applicable.
• Default Material:
  • Options: Selected materials from previous section

• Each procedure code will have a default material choice. When charting on the odontogram, the default material will display when using the code, however, if multiple materials were set for the code, the user can manually update the material.