When using Open Dental in Tight Integration with eClinicalWorks, as procedures are completed in Open Dental, they are sent to eCW for billing and claim purposes. This section assumes that the appointment (encounter) was previously created in eCW.

Send a Procedure to eCW

1. Access Open Dental from eCW by selecting View Dental Chart. The VisitID/AptNum is passed silently to Open Dental and an appointment will show in the Chart. It was transferred there via HL7 within 70 seconds of the last appointment edit in eCW.
2. If you haven't already added today's treatment planned procedures, chart the procedures with status treatment planned. See Enter Treatment.
3. In the Chart Module, double click on today's appointment to see treatment planned procedures. Highlight the procedures to attach. Any other procedures that have been completed already will be automatically highlighted.
4. Verify the correct provider is attached to the appointment.
5. Change the appointment status from Scheduled to Complete, then click OK.
6. This will generate any default Procedure Notes, mark the procedures as Complete (which does not mean you are finished, only that these are the procedures you have done today), and apply the associated provider to the completed procedures.
7. If you use Procedure Group Note, highlight your completed procedures, then right click and select Group Note to enter.
8. During the course of the appointment, procedures may still be altered, added, removed, etc.
9. When patient treatment is done, open the appointment and check the procedures one last time for accuracy.
10. Signatures and procedure notes are verified prior to Finish & Send if boxes Require Signatures for Procedure Notes and Don't Allow Incomplete Procedure Notes are checked.
11. Click Finish & Send to close Open Dental and send the procedures to eCW.

If the procedures were sent incorrectly and need to be altered, open the appointment again and click Revise. This allows you to fix them in Open Dental. They will also need to be separately fixed in eCW. The user must have the security permission EcwAppointmentRevise in order to revise.

Duplicate Procedures

Duplicate procedures are checked for and removed from HL7 messages. In order to send more than one of the same procedure, there must be a distinguishing characteristic (e.g. tooth number, tooth range, surface, or procedure fee). The recommended property is tooth number. We do not recommend procedure fee.

• If it is a filling or crown, the distinguishing characteristic is Tooth Number.
• If a procedure doesn't have a tooth treatment area, create a dummy code that will have that treatment area. For example, to add multiple PA's, create a code D0230b with a treatment area of tooth. For each additional PA you complete for the patient, select a different tooth so they all show up in the HL7 DFT message. The HL7 service will remove any characters after the first five digits, so the 'b' would not be included in the DFT message.

Full-mouth Series Procedure Button

A custom procedure button can be set up to handle a 6 PA series. The following is required:

• Two procedure codes must be set up meeting the following requirements:
  • Procedure Code 1: Abbreviation = PA, Treatment Area = Tooth
  • Procedure Code 2: Abbreviation = PA+, Treatment Area = Tooth
• The procedure codes must be added to the Procedure Button in the following order:PA, PA+, PA+, PA+, PA+, PA+

Codes must be added in order with no other procedures. The standard PA (D0220) and PA+ (D0230) procedure codes can be used, if they meet the setup requirements. Otherwise, follow the steps to create cuplicate procedures that meet the requirements.

When the button is used, it will create a PA procedure attached to tooth 3 as well as 5 additional PA+ procedures with tooth numbers of 8,14,19,24, and 30. These procedures will not trigger the duplicate procedures warning for HL7 because they have unique tooth numbers to distinguish them.