Edit Procedure Code Window
Procedure code properties and default notes can be entered on the Edit Procedure Code window. To open, in the main menu, click Lists, Procedure Codes, then double click an existing code.
Below is a description of each option.
Time Pattern: Use the vertical slider on the left to set the procedure time allotment. By default, each square represents 10 minutes. To change the default, see Setting the Time Increment. Slashes (/) indicate assistant time, X's indicate provider time. Click on an X or / to toggle to the other. Procedure time is used to determine default appointment length. See Time Bars for more detail.
Proc Code: The code itself. It can be up to 15 digits long. All codes starting with D will be shortened to 5 characters before being included on a insurance claim. For example, you can have two different codes for nitrous, with the difference being a letter that is added to the end of a standard D code. When sent to insurance, only the standard 5 digit code will be used.
Note: Once created, codes can't be changed or deleted. Instead move it in an obsolete category.
Alt Code: Associate an alternate code. Useful for some Medicaid plans like Dentical. See Medicaid Insurance Plans.
Medical Code: Associate a medical code. The medical code must already exist. See Cross Coding Procedure Codes to Medical Codes. Cross coding only affects medical claims. It does not affect what shows on Continuity of Care documents (CCDs).
Ins Subst Code: Associate an insurance substitution code and optionally set an Only if condition. The substitute code will be used to calculate estimates for procedure downgrades (when insurance reduces the allowed amount of a procedure). See Procedure Downgrades.
Description: Only non-ADA code descriptions can be edited. Automatically update ADA code descriptions using Procedure Code Tools.
Abbreviation: Can be edited.
Base Units: Typically for Medical Insurance claims. When calculating a procedure fee, the standard fee is increased based on the base unit, thereby increasing the billed fee. The base unit calculates the fee and time pattern using an additive process.
For example, the procedure code for Nitrous Oxide may have a time pattern of 15 minutes (base unit of 0) and a fee of $100. During the procedure, you may typically use Nitrous Oxide for a longer period of time. Instead of adding the procedure to the chart multiple times, increase the base unit.
There is a checkbox on the Insurance Plan Edit window for "Claims show base units" which shows the base unit on the medical claim form.
Drug NDC: National Drug Code number.
Default Revenue Code: A 3-digit code sometimes used for institutional claims. It tells insurance where the patient was when they received insurance or the type of item they received. It will show as the default Revenue Code on the Procedure Info - Medical Tab.
Color Override: Override the default color for this procedure on the Graphical Tooth Chart. Usually colors are based on procedure status, such as Treatment Planned or Completed, not on individual procedure code. However in rare situations you may want a procedure code to always show in one color. For example, implants look better as always gray, instead of red, blue, or green. Click none to remove the override.
Do not usually bill to Ins: Determines the default setting of the 'Do Not Bill to Ins' checkbox on the Procedure Info - Financial Tab. Useful to identify procedures that are not usually sent to insurance (e.g. non-standard D codes, crown seats).
Is Hygiene procedure: Check this box to automatically assign the procedure to the hygiene provider when scheduling an appointment with two providers. See Edit Appointment for an explanation of Hygiene provider.
Is Prosthesis: Determines whether or not additional Prosthesis Replacement fields will show on the Procedure Info window.
Assign to Prov: Assign a specific provider to this procedure. For example, create a procedure for selling mouthwash from the dental office, then assign the procedure to a dummy provider. This avoids inflated production numbers on real providers. The provider selected here will be assigned to this procedure when it is created and when it is set complete.
Paint Type: Determines how the procedure will be drawn on the Graphical Tooth Chart.
Treatment Area: Determines the surface and tooth options available when charting the procedure (Procedure Info window).
Category: Select the category this procedure code will be grouped under. Customize category options in Definitions, Proc Code Categories.
Default Note: This is the default Procedure Note that will automatically copy to the patient's chart when the procedure is Set Complete. Notes can include anything that normally goes into your chart notes.
Auto Note: Click Auto Note to insert an Auto Note in the default note text [[AutoNoteName]]. Once a procedure is set complete, reopening the Procedure Info window will trigger auto note prompts. Once responses are entered, the entire note will be copied into the Notes area. Note: Prompts will only be triggered if the preference for 'Procedures Prompt for Auto Note' in Chart Module Preferences is checked.
Incomplete Notes: To remind staff to enter specific information in the note, use two quotes "" in the note without anything in between (Example: Due Date ""). Staff must then enter information between the quotes once the procedure is completed (Procedure Info window). If they do not, a red Incomplete Note warning will appear above the note. Completed procedures with incomplete notes show on the Incomplete Procedure Notes Report.
Notes and Times for Specific Providers: Lists provider-specific default notes and/or time allotments for the procedure. To create a new note:
Provider-specific notes can be deleted without disturbing patient data.
Default Claim Note: Enter a note that will automatically copy to the Claim Note field when a claim is created that includes this procedure. See Edit Claim - General Tab.
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