DXR Quick Reference Guide

Transcription

1 DXR Quick Reference Guide Ex Tx Cc Re Exams Treatment Plans & Checklists Case Completes Please Click one! Referrals and Consults

2 DXR Quick Reference Guide Ex Exams 1. Exam Types 2. New Patients 3. DXR Checklist 4. Transfer Patients (D0006) 5. Audits for Transfer Patients 6. Checklist for D0006

3 Ex 4 Basic Exam Types D Periodic Exam - for patients who require a routine exam and have been examined in the last months D Comprehensive Exam - for patients whose condition has changed significantly and require a comprehensive exam or have not been examined in the last 24 months, also for new patients. D Administrative Re-examination code - Use this code when a patient of record requires a re-examination (usually due to a transfer from another student or an outside referral). This is a No-Charge exam and is to be performed on ALL transfer cases and Outside referrals. If the patient has not had an approved exam in the last 12 months they must go through DXR first D0003,D Case Complete Exams -see section on Case Completes

4 Ex Patient's First Appointments New Patients For a New Patient requiring Comprehensive care (exluding Complete dentures) they will get a Work-up appointment with OME to begin your COE (Comp Oral Eval D0150) then they will have their treatment plans evaluated at the DXR appointment. For a New Patient requiring Complete dentures - go directly to a Removable Prosthodontic chair

5 Ex D Re-Examination Code ALL TRANSFER PATIENTS REQUIRE A D0006 BEFORE RESTORATIVE WORK IS STARTED

6 Ex Student D0006 Audit **In order to schedule your transfer patient for a work-up or a restorative (direct or indirect) procedure you must complete the following audit on your record. Current Accurate Models Up to date Radiographs with Interpretation - following ADA 2004 guidelines Full mouth Probing Depths Approved and Signed Phased Treatment Plan - Chart additions vs Tx Plan (Chart adds are not acceptable TX Plans) Examination (D0003, D0005, D0120, D0150 or Prophy) in last 12 mos If 2 or more are not satisfactory then you will need to schedule your first appointment for a work-up in a Operative or Fixed chair.

7 Ex

8

9 Ex Patient's First Appointments Transfer Patients Make sure Audit is done before you schedule your patient! Transfer patients (typically from a senior to a junior) will usually go into a Restorative chair to begin the D0006 (Re-examination code). If the patient passes the audit then the faculty may complete the D0006, and if time permits, the student may attempt a restorative procedure (Operative or Fixed) If the patient's record fails the audit, the student will need to complete the Work-up in the Restorative chair and then schedule an appointment in DXR. The D0006 code will be left In-Process until the the DXR appointment, when the faculty at that time will complete the code.

10 Ex D Re-Examination Code Expectations for a D0006: Students are to Audit their own patient records before appointments. This is a no-charge re-examination of the patient. Consider the D0006 much like a new patient DXR. Often these records are the most challenging to sort through. Please do not expect to do any other treatment for your patient until the D0006 is completed. Once the D0006 is completed you may begin restorative care. This expectation is designed both protect the patient and provide an opportunity to familiarize yourself with the record prior to treatment.

11 Ex D Re-Examination Record Checklist Updated films and Radiographic Interpretation 'In-Progress' tab has procedures that accurately reflect the Treatment Plan Odontogram confirmed Probing depths confirmed and Perio consult as needed Confirm Exam tab folders CRA and Exam within last 12 months Review prior TX Plans - make sure treatment has been followed as sequenced

12 Ex Student DXR Checklist Updated films/radiographic Interpretation - Completed Odontogram Confirmed & Corrected Probing Depths Confirmed and Perio consult PRN Confirm Exam Tab Folders with Summaries (Pre-med Req?) CRA with CRA Tx Plan Hand-articulated Study Casts Properly Sequenced Phase 1, 2 and 3 (TPB Prep?) Plan/s

13 DXR Quick Reference Guide Tx Treatment Plans & Checklists 1. TX Plan Phases - definitions 2. Phase 1 and 2 3. Phase 3 4. Implant Phase 3 5. Changing TX Plans

14 Tx Treatment Plan Phases Phase 1 - Disease control, emergency care and preparatory steps. This phase would also include Periodontal treatment, necessary Consults or Exploratory procedures (i.e. caries excavation) that would assist in the final diagnosis and treatment plan for future phases. Phase 2 - Direct Restorative. This phase would also include bleaching trays, preparation procedures for Phase 3 treatment plan, and may be the final Phase if no Indirect restorations are indicated. Phase 3 - Indirect Restorative. This phase would include both Fixed and Removable along with Implant placement and other surgical or specialty procedures that would directly prepare a patient for other Phase 3 treatment. Implant Phase 3- This may include a limited implant TX plan - these plans need to be approved by Fixed Prosthodontic Faculty at the DXR appointment NOTE: Often Phase 1 and 2 are combined as one plan. While this is often accomplished it is necessary to ensure that the treatment is sequenced appropriately.

15 Tx Phase 1 and 2 Preparatory and Direct Restorative Tx Plan Periodontal Phase 1 * D Periodontal Exam D???? - Prophy D???? - Fluoride D???? - OHI *If a patient requires periodontal procedures beyond an adult prophy **See section on Case Completes Direct Restorative Phase 2 When Phase 3 is indicated: **D Operative Case Complete D Office Visit - used for Occlusal Exam D Extensive TX Planning When Phase 3 is NOT indicated: **D CDM Case Complete (all treatment plans are completed OR patient refuses to continue with approved TX plan)

16 Tx Phase 3 - Indirect TX Plan Surgical tx for Phase 3 care may be included in these TX plans These plans will not be approved at the DXR appointment!!! D CDM Case Complete (all treatment plans are completed OR patient refuses to continue with approved TX plan)

17 Tx Implant Phase 3 ex - Implant Phase 3 #14 *Implant Phase 3 plans are approved by the Fixed faculty at the DXR appt These plans are limited in nature and only recommended in certain cases when there are no major oral diseases to control An example of this plan may include a patient who requires an implant in an ideal situation. In order to get an 'Implant Phase 3' plan approved Having 'Implant Phase 3' plans help at your DXR appt you must have a Tx plan ready expedite needed surgical referrals!

18 Tx Treatment Plan CHANGES IF DURING YOUR TREATMENT THE PLAN CHANGES OR NEEDS MODIFICATION... -YOU MUST MAKE A NEW PLAN!!! THIS PLAN MUST BE APPROVED BY FACULTY AND PATIENT YOU DO NOT NEED TO GO BACK THROUGH DXR TO MODIFY TX PLANS

19 DXR Quick Reference Guide 1. D0003 Operative Case Complete 2. D0003 Checklist 3. D0005 CDM Case Complete 4. D0005 Checklist Cc Case Completes

20 Cc D0003 Operative Case Complete D Dept Case Complete - used in Junior Clinic to ensure all of the Phase 1 and 2 has been completed Usually performed at the conclusion of the Direct Phase 1 and 2 Tx plan. This must be completed before Phase 3 Indirect Restorations are started

21 Cc D0003 Operative Case Complete CHECKLIST Phase 1 and 2 have been completed (including CRA TX - ie Fluoride varnishes) No Phase 1 or 2 treatment in the 'In-Progress' tab (unless an approved note for the D0003 explains reason for leaving treatment, i.e. "Board lesion") Radiographs are current Patient is Responding well to treatment and no other Phase 1 and 2 care is required

22 Cc D0005 Case Completes D CDM Case Complete - used when all treatment is rendered, or patient refuses care (must note). This may require a separate appointment and additional radiographs, usually performed with DXR faculty This code should conclude all active care!!! No treatment left in the 'In-Progress' tab

23 Cc D0005 Case Complete CHECKLIST ALL PHASES have been completed (including CRA TX - ie Fluoride varnishes) No treatment present in the 'In-Progress' tab All referrals in record have been addressed Radiographs are current Patient is Responding well to treatment and no other treatment is needed

24 DXR Quick Reference Guide 1. Guidelines for Referrals/Consults 2. Implant Phase 3 Consults Re Referrals and Consults

25 Re REFERRAL AND CONSULTS Make sure the Referral and Consult (D9310) is also appropriately phased in the TX plan as well For each referral generated, there should be an accompanying Consult (D9310) in the treatment plan with the appropriate Discipline listed Please make sure you complete the Referral prior to your DXR appointment In certain cases the DXR faculty may not approve your referral until you are at a specified point in your TX Plan Sequence (ie: Implant placement)

26 Re REFERRAL AND CONSULTS Implant Phase 3 TX Plans Implant referrals go to Patient Services and they determine where the implant is to be sent! Patient Services require a completed TX plan reflecting the implant treatment (surgical and restorative) that has been approved by the faculty and patient.