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. Slash (/) indicates assistant time, X indicates provider time. Click X or / to toggle to the other. Procedure time is used to determine default appointment length. See Time Bars for more details.

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 / Flat Co-Pay 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 a an EHR CCD (summary of care).

Ins Subst Code: Associate an insurance substitution code and optionally set an Only if condition. The substitute code is used to calculate downgraded estimates for procedures (when insurance reduces the allowed amount of a procedure). See Procedure Estimate Downgrades.

Description: Only non-ADA code descriptions can be edited. Automatically update ADA code descriptions using Procedure Code Tools.

Abbreviation: Can be edited.

Layman's Term: Enter simpler language to describe the procedure. It will show as the procedure description in Treatment Plans, the Chart Module, and the Account Module.

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. Base Unit = 0 (standard fee) Base Unit = 1 (standard fee + standard fee) Base Unit = 2 (standard fee + standard fee + standard fee).

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 Edit Insurance Plan 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 Procedures - 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 Procedures - Financial Tab. Useful to identify procedures that are not usually sent to insurance (e.g. non-standard D codes, crown seats).

Is Hygiene procedure: See Edit Appointment Window for an explanation of Hygiene provider.

Is Prosthesis: Determines whether or not additional Prosthesis Replacement fields will show on the Procedure Info window.

Is Radiology: Typically used for EHR to designate a procedure as an x-ray.

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.

Bypass Global Lock Date: Determines whether or not this procedure will be affected by the Global Lock Date (if turned on).

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: The category this procedure code will be grouped under. Customize category options in Definitions: Procedure Code Categories.

Default Fees: The global fees for this procedure code, for each Fee Schedule.

Completed Note: Default procedure note that automatically copies to the Procedure Info window, Notes field when the procedure is set complete.

TP'd Note: The default Procedure Note that automatically copies to the Procedure Info window, Notes field when the procedure has a status of treatment planned.

Note:
  • Use two quotes "" to remind staff to enter specific information in a note (Example: Due Date ""). If the information is not completed, a red Incomplete Note warning will appear above the note. To view a list of completed procedures with incomplete notes, see Incomplete Procedure Note Report. Other examples: composite shade, crown shade, denture shade, due date, blood pressure, nitrous levels, etc.
  • To insert an Auto Note template in a Completed or TP'd Note, click Auto Note. If Procedures Prompt for Auto Note in Chart Module Preferences is checked, opening the Procedure Info window will trigger any auto note prompts

Default Claim Note: A default note that automatically copies to the Claim Note field when a claim or preauthorization is created that includes this procedure. See Edit Claim - General Tab.

Notes and Times for Specific Providers: When specific provider's have different completed or TP'd notes and/or time allotments, create a provider specific note.

  1. Click Add Note.
  2. Highlight the provider.
  3. On the left, select the procedure's time pattern for this provider, if different.
  4. Change the provider's default procedure note, if different.
  5. Click OK to save.

Provider-specific notes can be deleted without disturbing patient data.