Home User Manual Discussion Forum Search

Canada - Procedures and Lab Fees

For Canada users, the Procedure Edit window has a Canada tab.

Procedure Type Code
By default, none is selected.  Change the type code if you need it to go out on a Claim.

Lab Fees
Lab fees are treated just like ordinary Procedures except for a few key differences. Lab fees cannot be attached to appointments directly. Instead they are attached to procedures, which then can be attached to Appointments.

  1. For procedure codes that are lab fees (99xxx), go to the Procedure Code Edit window and check the "Is Lab Fee" box.




  1. In the Chart module, treatment plan the regular non-lab procedure.
  2. On the non-lab procedure's Procedure Info, Canada tab, enter the lab fees (up to two can be entered).  If the carrier supports version 04 E-claims, both fees are sent.  If the carrier supports version 02 e-claims, then only one lab fee is sent.
  3. Click OK.

For each lab fee entered, one lab procedure with code 99111 is automatically created (beginning with "^^" to visually indicate it is attached). The lab procedures show in the Chart module and the Account module directly below the procedure it is attached to.



  • Lab procedures cannot be attached to claims.
  • When sending e-claims, any lab fees attached to a procedure will be sent on the same line as the procedure.
  • To remove a lab fee, edit the procedure and clear out the lab fee amount on the Canada tab.
  • Lab fees can also be detached from procedures by right-clicking in the Chart module progress notes and choosing "Detach Lab Fee".

If the lab fee is not a 99111 code, then the lab fees can be manually entered into the Chart and attached to a non-lab procedure by highlighting both procedures and selecting "Attach Lab Fee".  In this case, it will not show in the Procedure Code Edit window.

Insurance Estimates
Version 16.3 and greater: When the insurance plan is a 'Category Percentage' plan, the percentage will be applied to the total of the procedure and attached lab fees. Example: 50% coverage. Procedure fee is $100. Lab fee is $10. Estimate = (100 + 10) * 50% = $55

Version 16.2 and earlier: When the insurance plan is a 'Category Percentage' plan, the percentage is applied to the procedure only.
Example: 50% coverage. Procedure fee is $100. Lab fee is $10. Estimate = (100) * 50% = $50

 

Open Dental Software 1-503-363-5432