Dental Information Guide 2014

Dental Information Guide 2014 With guide to tooth specific information Fees effective from 1 June 2014

CONTENTS Comments & Feedback To help us improve our services, we would appreciate your comments or suggestions about this publication. Please send your comments to: Customer Services Practitioner Services Dental & Ophthalmic Gyle Square 1 South Gyle Crescent Edinburgh EH12 9EB Telephone the Helpdesk on: 0131 275 6300 NSS.psddental@nhs.net Code/Item guide Discretionary fee list Incomplete metal dentures Incomplete acrylic dentures Item 1 General examination time-bars Information notes relating to Item 1 Item 1 Orthodontic examination time-bars Information notes relating to Item 1 Item 10 Periodontal treatment time-bars Information notes relating to Item 10 Combination codes - General Combination codes - Orthodontic Changes to free repair and replacement Miscellaneous information 3/4 5/6 7 8 9 10 11 12 13 14 14

JUNE 2014 CODE/ITEM GUIDE MAXIMUM PATIENT - 384 EXAMINATION 1A 1B 1C 1D X-RAYS - Registered/Occasional 2A[1] / 49 Small 2A[2] / 49 Medium 2A[3] / 49 Large Panoral Ceph [ORTHO] STUDY MODELS 2B Upper + Lower Duplicate set Single PHOTOGRAPHS 3 SCALING X-rays to be available for 10C 10A 10B 10B Incomplete [1st Visit] 10C 1-4 teeth 5-9 teeth 10-16 teeth 17 or more teeth Additional fee for sextants FILLINGS 14A[1] Single surface 14A[2] Two surfaces 14A[3] MO or DO 14A[4] MOD 14B Tunnel Single filling Double filling 14C[1] Resin Single filling Double filling Acid etch One angle Incisal edge Two angles Cusp tip 14C[2] Glass ionomer Single filling Double filling Pin 14D SEALANT RESTORATIONS 14H Sealant only 14I Resin 14J Resin + ionomer 14G Single filling Double filling CODE 0101 0111 0121 0131 0201 / 4901 0202 / 4911 0203 / 4921 0204 / 4931 0205 0211 0212 0213 0301 1001 1011 1000 01 1021 1021 1021 1021 1022 1401 1402 1403 1404 1411 1412 1421 1420 1422 1423 1424 1425 1426 1427 1431 1481 1482 1483 1461 1462 MAXIMUM FILLING S Combinations of materials WITHOUT pins / acid etch / cusp tip 1470 32.15 25.72 Combinations of materials WITH pins / acid etch or cusp tip 1471 35.80 28.64 ROOT TREATMENTS X-rays to be available 15A Incisor 1501 48.65 38.92 Upper premolar 1502 66.30 53.04 Lower premolar 1503 57.45 45.96 Molar 1504 101.85 81.48 15B Vital pulpotomy 1511 19.30 15.44 Remember to enter code for 1st crown [1700] or veneer [1600] Do not use occasional codes [items 47-60] for referral or partner/associates patients 8.45 12.65 26.40 4.15 4.15 5.50 8.70 12.90 19.05 18.65 11.70 9.20 4.15 13.25 32.15 16.05 41.00 50.05 59.15 66.25 8.30 9.00 13.25 17.50 23.15 17.50 23.15 17.00 26.40 5.50 1.10 9.00 12.90 15.40 21.05 7.05 8.30 11.70 17.50 15.40 22.95 PATIENT 3.32 3.32 4.40 6.96 10.32 15.24 14.92 9.36 7.36 3.32 10.60 25.72 12.84 32.80 40.04 47.32 53.00 6.64 7.20 10.60 14.00 18.52 14.00 18.52 13.60 21.12 4.40 0.88 7.20 10.32 12.32 16.84 5.64 6.64 9.36 14.00 12.32 18.36 APICECTOMY X-rays to be available 15C Incisor Premolar Upper molar Additional fee for retrograde VENEERS 16 321/123 Additional fee for 1st veneer INLAYS 17A[1] Single surface 2 surfaces 2 surfaces involving the incisal 3 surfaces CROWNS 17B[1] Precious metal 17B[2] NON precious metal 17C Porcelain jacket crown 17D[1] Bonded precious 17D[2] Bonded non-precious 17E Acrylic Additional fee for 1st crown or inlay POSTS 17F[2] Metal alloy post 17F[3] Prefabricated post 17F[4] Pin / screw TEMPORARY CROWN 17G WITHOUT post WITH post RE-CEMENT - Registered / Occasional 17K / 51C Inlay Crown BRIDGES X-rays and study models to be available 18A[4] Retainer Bonded precious Bonded non-precious 18C[4] Pontic Bonded precious Bonded non-precious 18D Maryland retainer Pontic TEMPORARY BRIDGE 18F[1] Lab produced 18F[2] Other RE-CEMENT BRIDGE 18G[1] Maryland 18G[2] Any other bridge EXTRACTIONS - Registered / Occasional - Updated 21[1] / 52[1] 1 tooth Permanent 2 teeth or retained 3 or 4 teeth deciduous 5-9 teeth 10-16 teeth 17 or more teeth Additional fee for visits 21[2] / 52[2] 1 tooth Deciduous 2 teeth teeth 3 or 4 teeth 5-9 teeth 10-16 teeth 17 or more teeth Additional fee for visits CODE 1521 1522 1523 1541 1601 1600 1701 1702 1703 1704 1711 1712 1716 1721 1722 1726 1700 1732 1733 1734 1742 1743 1781 5111 1782 5112 1807 1808 1825 1826 1831 1832 1851 1852 1861 1862 2101 5201 2101 5201 2101 5201 2101 5201 2101 5201 2101 5201 2121 / 5206 2102 5202 2102 5202 2102 5202 2102 5202 2102 5202 2102 5202 2121 / 5206 43.00 59.15 69.70 9.20 107.40 8.30 69.70 98.40 89.45 130.65 116.35 89.45 87.60 133.35 119.75 71.50 8.30 37.05 19.30 9.20 15.40 21.75 11.10 11.10 141.10 128.65 80.20 69.70 41.00 78.35 18.25 6.75 30.40 16.10 8.30 15.00 23.15 30.40 41.00 50.05 6.75 PATIENT 34.40 47.32 55.76 7.36 85.92 6.64 55.76 78.72 71.56 104.52 93.08 71.56 70.08 106.68 95.80 57.20 6.64 29.64 15.44 7.36 12.32 17.40 8.88 8.88 112.88 102.92 64.16 55.76 32.80 62.68 14.60 5.40 6.64 12.00 18.52 24.32 32.80 40.04 5.40 8.30 15.00 23.15 30.40 41.00 50.05 6.75 3

JUNE 2014 CODE/ITEM GUIDE CODE PATIENT SURGICAL EXTRACTIONS - VISIT fee not applicable / X-rays to be available 22A Soft tissue only 2201 23.15 18.52 Bone removal on 1, 2 or 3s 4, 5, 6, 7 or 8s Impacted wisdom teeth 2202 2203 32.15 39.45 25.72 31.56 Upper NO DIVISION 2204 Lower NO DIVISION 2206 Upper WITH DIVISION 2205 Lower WITH DIVISION 2207 POST OPERATIVE TREATMENT 23A[1] Arrest of haemorrhage 2301 23A[2] Remove sutures 2302 23B Septic socket 2311 GENERAL ANAESTHETIC - Deleted 01/04/2001 SEDATION 25A[1] WITH ITEM 21 1-4 teeth 5-9 teeth 10-16 teeth 17 or more teeth 2551 2552 2553 2554 2560 25A[2] WITH OTHER ITEMS [adults only] < 10 10.01-25 25.01-50 > 50 2555 2556 2557 2558 25C[2] Inhalation 2573 18.65 Fee paid for 2573 is calculated as Inhalation @ 12.65 plus Supplement @ 6.00. The patient will only pay 80% of Inhalation 25C[2] Injection 2574 30.45 Fee paid for 2574 is calculated as Injection @ 22.65 plus Supplement @ 7.80. The patient will only pay 80% of Injection ACRYLIC DENTURES 27B[1] Full Upper + Lower 2730 182.80 27B[2] Full Upper Lower 2731 2732 114.05 27B[3] Partial 1-3 teeth 2733 2735 71.50 4-8 teeth 2733 2735 94.80 9 or more 2733 2735 112.75 Note 2738 maximum denture code no longer applies: Use Upper/Lower codes. 27C[1] Full 2741 27C[2] 27C[3] 27C[4] Part plate design 1-3 teeth 2743 4-8 teeth 2743 9 or more 2743 Single bar 1-3 teeth 2744 4 or more 2744 Multi bar 1-3 teeth 2745 4 or more 2745 REPAIRS 28A[1] 2801 28A[2] 2803 28A[4] Impression 2821 MAXIMUM REPAIR Upper 2810 01 Lower 2820 01 2742 2747 2747 2747 2748 2748 2749 2749 2802 2804 2822 2810 01 2820 01 41.00 48.35 51.80 57.35 26.40 8.30 8.30 26.40 30.40 35.80 44.55 89.20 26.40 48.35 69.70 89.20 161.15 164.65 180.65 187.80 173.60 189.55 180.65 202.25 17.25 25.00 8.00 39.45 39.45 32.80 38.68 41.44 45.88 6.64 21.12 24.32 28.64 35.64 71.36 21.12 38.68 55.76 71.36 10.12 18.12 146.24 91.24 57.20 75.84 90.20 128.92 131.72 144.52 150.24 138.88 151.64 144.52 161.80 EASING 28B RELINES 28C[1] 28C[2] 28C[3] ADDITIONS CODE Upper 2831 2851 2853 2855 28D[1] 28D[2] 28D[3] Clasp Tooth Gum 2861 2863 2865 addition fee - per denture Combinations of 2 or more additions with or without repairs fee applies per denture ORTHODONTIC APPLIANCE 2880 19 48.35 32A[1] 32A[2] 32A[3] 32A[4] 32A[5] Extra-oral traction Anchorage RETENTION 32B[1] 3201 3203 3205 3207 3211 3221 3222 First period Additional period 35 / 57A < 10 miles 10-40 miles over 40 miles RE-OPEN SURGERY - Registered/Occasional 35 / 57B < 1 mile over 1 mile ITEM 36 - MISCELLANEOUS TREATMENTS 36A Pathological exam 3601 12.65 10.12 36B Grinding 3611 2.95 2.36 36D Sensitive cement 3631 5.50 4.40 PRESCRIPTION - Registered/Occasional - cannot claim with treatment items 36E / 48 ACUTE INFECTION - Registered/Occasional 37 / 56 DRESSINGS - Occasional - Updated 3641 / 4801 3701 / 5601 4.60 8.00 3.68 6.40 50A[1] Permanent 1 tooth or retained deciduous 2 teeth Each additional 50A[2] Deciduous 1 tooth 2 teeth Each additional CODE Lower 2832 2852 2854 2856 2862 2864 2866 3202 3204 3206-3212 3223 3224 3231 3232 3501 / 5701 3502 / 5702 3503 / 5703 3511 / 5711 3512 / 5712 5001 5001 5001 5001 5002 5002 5002 5002 12.10 41.00 46.55 62.75 33.90 126.95 121.75 355.95 218.25 93.15 51.80 51.80 32.15 16.10 37.65 51.80 68.00 44.55 73.40 6.30 9.00 2.53 18.70 6.30 9.00 2.35 18.70 PATIENT 9.68 32.80 37.24 50.20 27.12 38.68 101.56 97.40 284.76 174.60 74.52 41.44 41.44 25.72 12.88 RETENTION APPLIANCES 32B[2] REPAIRS - Updated Removable Fixed Pressure 3233 3235 3237 3234 3236 3238 62.75 71.50 50.85 50.20 57.20 40.68 32C[1] 3241 3247 26.40 32C[2] One repair Each additional 3242 3242 3428 3428 32.15 8.30 32C[3] (upper + lower) 3230 41.00 IMPRESSION 3245 3246 8.00 REPLACEMENT APPLIANCES - REG 9 charge is decided by the Health Board 32E[1] Space maintainer 3281 50.05 40.04 32E[2] Removable 3282 68.00 54.40 32E[3] Simple fixed 3283 69.70 55.76 32E[4] Multiband 3284 130.65 104.52 32E[5] Functional 3285 80.55 64.44 DOMICILIARY VISITS - Registered/Occasional - supporting observations should be given 5.04 7.20 1.88 14.96 4JU

JUNE 2014 DISCRETIONARY LIST These are the more commonly used discretionary fee items. Some items are often claimed in a course of treatment with discretionary items, and also shown here. The code + fee should be entered onto the GP17. All other discretionary fees must be obtained by contacting Practitioner Services on 0131 275 6300. Enter on the GP17 as previously described. ANAESTHETICS - For treatment other than item 21 use codes as detailed below CODE NO GENERAL ANAESTHETIC Deleted from the statement of dental remuneration 24A3 [CHILD] 24A2 [ADULT] SEDATION TREATMENT VALUE UP TO 10.00 10.01-25.00 25.01-50.00 OVER 50.00 25A3 [CHILD] 2561 01 2561 02 2561 03 2561 04 25A2 [ADULT] [non-discretionary] 2555 01 2556 01 2557 01 2558 01 26.40 48.35 69.70 89.20 PATIENT [ADULT only] 21.12 38.68 55.76 71.36 TREATMENT DESCRIPTION CODE NO PATIENT RE-CEMENT VENEER 4003 03 15.25 12.20 SCALING - Incomplete 10B [1st Visit only] 1000 01 16.05 12.84 OPERCULECTOMY 2221 39 22.65 18.12 This group has both discretionary and non-discretionary elements RE-CEMENTING A CROWN + PROVIDING A NEW POST 1. Cast metal alloy core + post [F2] 1771 24 65.80 52.64 2. Radix Anchor or Kurer Crown Saver 1771 24 65.80 52.64 3. Prefabricated post [F3] 1771 23 48.00 38.40 4. Pinned core [F4] 1771 21 32.40 25.92 Removal of Crown prior to repair 1771 11 16.65 13.32 Removal of Post prior to repair [this item is non-discretionary] 1744 01 16.90 13.52 REPAIR OF A PORCELAIN USING A SPECIAL PORCELAIN REPAIR KIT 1 unit 1771 14 26.40 21.12 2 units 1771 15 39.70 31.76 3 units 1771 16 52.90 42.32 RE-CEMENTING A BRIDGE + PROVIDING A NEW POST 1. Cast precious metal core + post [B1] 1871 11 63.85 2. Cast non-precious metal alloy core + post [B2] 1871 12 52.30 3. Radix Anchor or Kurer Crown Saver 1871 12 52.30 4. Prefabricated post [B3] 1871 13 45.10 5. Pinned core [B4] 1871 10 34.95 RE-CEMENTING A BRIDGE + PROVIDING 2 NEW POSTS 1. Cast precious metal core + post [B1] 1871 26 102.00 2. Cast non-precious metal alloy core + post [B2] 1871 27 78.65 3. Radix Anchor or Kurer Crown Saver 1871 27 78.65 4. Prefabricated post [B3] 1871 28 64.45 5. Pinned core [B4] 1871 25 44.15 5

JUNE 2014 DISCRETIONARY LIST DESCRIPTION REPAIR TO PORCELAIN BY RE-BONDING PORCELAIN IN A LAB CODE NO PATIENT 1 unit 1871 07 39.65 2 units 1871 08 59.50 3 units 1871 09 79.20 REPAIR TO PORCELAIN USING A SPECIAL PORCELAIN REPAIR KIT 1 unit 1871 14 26.40 2 units 1871 15 39.65 3 units 1871 16 52.80 Sectioning / Removal of Bridge Repair of Bridge using a Porcelain Veneer 1871 01 1871 23 24.20 115.65 REPAIRS INVOLVING METALWORK [SOLDERING/WELDING] Repair fee [Fracture/Re-fix tooth] [this item is non-discretionary] 2801 01 17.25 Impression fee [this item is non-discretionary] 2821 01 8.00 Metalwork fee 2811 07 23.50 Total 48.75 Repair fee [Clasp] Impression fee [this item is non-discretionary] [this item is non-discretionary] 2803 01 2821 01 25.00 8.00 Metalwork fee 2811 07 23.50 Total 56.50 This group has both discretionary and non-discretionary elements ADDITIONS INVOLVING METALWORK [SOLDERING/WELDING] Addition [Tooth] [this item is non-discretionary] 2863 01 Metalwork fee 2871 15 23.50 18.80 Total 52.10 41.68 Addition [Clasp] [this item is non-discretionary] 2861 01 33.90 27.12 Metalwork fee 2871 15 23.50 18.80 Total 57.40 45.92 Note - Do not claim an impression fee as this is already included in the Addition fee Stripping Fee 2871 14 24.20 19.36 Reconstruction of a metal denture [this item is non-discretionary] Upper 1-3 teeth 2733 01-03 71.50 57.20 4-8 teeth 2733 04-08 94.80 75.84 9+ teeth 2733 09-15 112.75 90.20 Note When reconstructing a metal denture involving stripping, claim the stripping fee 2871 14 and add the fee for the denture corresponding to the number of teeth involved. [this item is non-discretionary] Lower 1-3 teeth 4-8 teeth 9+ teeth 2735 01-03 2735 04-08 2735 09-15 71.50 94.80 112.75 57.20 75.84 90.20 Example To reconstruct a partial upper denture involving 5 teeth: Add 2871 14 to 2733 05: 24.20 + 94.80 = 119.00 6

JUNE 2014 INCOMPLETE METAL DENTURES CODES AND S 62E - 25% 62F - 50% 6240 01 F / F 45.70 6250 01 F / F 91.40 6241 01 F / - 28.50 6251 01 F / - 57.05 6242 01-03 P / - 17.90 6252 01-03 P / - 35.75 6242 04-08 P / - 23.70 6252 04-08 P / - 47.40 6242 09 or more P / - 28.20 6252 09 or more P / - 56.40 6243 01 - / F 28.50 6253 01 - / F 57.05 6244 01-03 - / P 17.90 6254 01-03 - / P 35.75 6244 04-08 - / P 23.70 6254 04-08 - / P 47.40 6244 09 or more - / P 28.20 6254 09 or more - / P 56.40 62G - 70% 62H - 85% 62i - 95% Horseshoe / Plate Horseshoe / Plate Horseshoe / Plate 6261 01 F / - 112.80 6271 01 F / - 137.00 6281 01 F / - 153.10 6263 01-03 P / - 115.25 6273 01-03 P / - 139.95 6283 01-03 P / - 156.40 6263 04-08 P / - 126.45 6273 04-08 P / - 153.55 6283 04-08 P / - 171.60 6263 09 or more P / - 131.45 6273 09 or more P / - 159.65 6283 09 or more P / - 178.40 6262 01 - / F 112.80 6272 01 - / F 137.00 6282 01 - /F 153.10 6266 01-03 - / P 115.25 6276 01-03 - / P 139.95 6286 01-03 - /P 156.40 6266 04-08 - / P 126.45 6276 04-08 - / P 153.55 6286 04-08 - /P 171.60 6266 09 or more - / P 131.45 6276 09 or more - / P 159.65 6286 09 or more - /P 178.40 Skeleton - Single Connecting Bars Skeleton - Single Connecting Bars Skeleton - Single Connecting Bars 6264 01-03 P / - 121.50 6274 01-03 P /- 147.55 6284 01-03 P /- 164.90 6264 04 or more P / - 132.70 6274 04 or more P /- 161.10 6284 04 or more P /- 180.05 6267 01-03 - / P 121.50 6277 01-03 - / P 147.55 6287 01-03 - / P 164.90 6267 04 or more - / P 132.70 6277 04 or more - / P 161.10 6287 04 or more - / P 180.05 Skeleton - Multiple Connecting Bars Skeleton - Multiple Connecting Bars Skeleton - Multiple Connecting Bars 6265 01-03 P / - 126.45 6275 01-03 P / - 153.55 6285 01-03 P /- 171.60 6265 04 or more P / - 141.55 6275 04 or more P / - 171.90 6285 04 or more P /- 192.15 1 6268 01-03 - / P 126.45 6278 01-03 - / P 153.55 6288 01-03 - /P 171.60 6268 04 or more - / P 141.55 6278 04 or more - / P 171.90 6288 04 or more - / P 192.15 7

JUNE 2014 INCOMPLETE ACRYLIC DENTURES CODES AND S 62A - 25% 62B - 50% 6200 01 F / F 45.70 6210 01 F / F 91.40 6201 01 F / - 28.50 6211 01 F / - 57.05 6202 01-03 P / - 17.90 6212 01-03 P / - 35.75 6202 04-08 P / - 23.70 6212 04-08 P / - 47.40 6202 09 or more P / - 28.20 6212 09 or more P / - 56.40 6203 01 - / F 28.50 6213 01 - / F 57.05 6204 01-03 - / P 17.90 6214 01-03 - / P 35.75 6204 04-08 - / P 23.70 6214 04-08 - / P 47.40 6204 09 or more - / P 28.20 6214 09 or more - / P 56.40 62C - 66 2 / 3 % 62D - 95% 6220 01 F / F 121.85 6230 01 F / F 173.65 6221 01 F / - 76.05 6231 01 F / - 108.35 6222 01-03 P / - 47.65 6232 01-03 P / - 67.90 6222 04-08 P / - 63.20 6232 04-08 P / - 90.05 6222 09 or more P / - 75.15 6232 09 or more P / - 107.10 6223 01 - / F 76.05 6233 01 - / F 108.35 6224 01-03 - / P 47.65 6234 01-03 - / P 67.90 6224 04-08 - / P 63.20 6234 04-08 - / P 90.05 6224 09 or more - / P 75.15 6234 09 or more - / P 107.10 Please note: From 01/12/98 the maximum denture code/fee no longer applies - use upper and lower codes. When a patient returns to have a denture fitted, submit a GP17 to us requesting a balance fee to be paid. Do not enter item 27 codes when claiming incomplete dentures. You must observe the requirements of narratives and provisos in the statement of dental remuneration for each item. 8

ITEM 1 - GENERAL EXAMINATION TIME-BARS USING THE TABLE Identify the exam being claimed in left-hand side of the table and cross-reference along the table to ensure a previously claimed exam has not been paid within the stated time period. EXAMPLE If you wish to claim an item 1(a) exam, and you previously claimed an item 1(c) you would need to wait 5 complete. You cannot claim an If you have Item 1a Item 1b Item 1c Item 1a Trauma carried out an Item 1a Item 1b Item 1c INFORMATION NOTES HISTORICAL CLAIM AND TIME-BAR PERIOD In the last 5 complete In the last 23 complete In the last 5 complete In the last 23 complete In the last 5 complete In the last 23 complete In the last 23 complete (see note 8) 1 Time-bar checks are carried out against a history for the same dentist. 2 The same den iginal dentist, a partner/principal/associate, or another dentist with whom the original den rangement. 3 The examination time-bar is calculated based on the acceptance date of the claims. 4 The time-bars do not apply if the examination is a result of trauma. The trauma box must be ticked and observations given. 5 To calculate complete, for example 5, add 6 months, the time bar will expir y of the sixth month. For example: Claim on 18/03/2002, the next claim is possible on or after 01/09/2002. 6 If a patient returns after their registration has lapsed, the 23 month time-bar for Item 1(b) or 1(c) examinations still applies. 7 The Item 1(c) time-bar does not apply when the total fee for treatment claimed exceeds 600.00 8 Item 1(a) is most likely to be claimed for a regular patient, when the dentist is familiar with the patient s oral health. 9 Item 1(b) is most likely to be claimed for a patient who is new to the practice. Charting of the patient s periodontal status must be reported in the patient record. 10 Item 1(c) may be claimed in connection with Item 10(c); Item 18; when treatment is of special complexity involving Items 16, 17; in dentate cases involving Item 27(b) and 27(c), and when the total fee for treatment claimed exceeds 600.00. 11 One additional Item 1(a) may be claimed for patients who are pregnant or who have borne children in the past 12 complete. 9

ITEM 1 - ORTHODONTIC EXAMINATION TIME-BARS USING THE TABLE Identify the exam being claimed in the left-hand side of the table and cross-reference along the table to ensure a previously claimed exam has not been paid within the stated time period. EXAMPLE If you wish to claim an item 1(b) Orthodontic exam, and you previously claimed an item 1(c) you would need to wait 23 complete. You cannot claim an If you have Item 1a Item 1b Item 1c carried out an Orthodontic Orthodontic Orthodontic In the last 5 complete In the last 5 complete Item 1a Orthodontic In the last 23 complete In the last 23 complete Item 1b Orthodontic Item 1c Orthodontic HISTORICAL CLAIM AND TIME-BAR PERIOD In the last 5 complete In the last 5 complete In the last 5 complete In the last 23 complete In the last 23 complete INFORMATION NOTES 1 Orthodontic examination fees can only be paid for a patient who has an established or developing malocclusion. 2 An Item 1(c) examination is only payable when study casts and radiographs (if appropriate) are available, and are recorded as available on the claim; the referring dentist or hospital may provide models or radiographs for the orthodontist. 3 An item 1(a) and an item 1(c) are not payable where there are no permanent teeth present. 4 An Item 1(c) claim on a GP17(0) does not bar simultaneous claims for Items 1(a) or 1(b) on GP17 forms when the dentist is also responsible for the patient s general care. 5 Orthodontic examinations must be made using GP17(0) forms, with the appropriate information detailed. 10

ITEM 10 - PERIODONTAL TREATMENT TIME-BARS USING THE TABLE Identify the exam being claimed in left-hand side of the table and cross-reference along the table to ensure a previously claimed exam has not been paid within the stated time period. EXAMPLE If you wish to claim an item 10(b), and you previously claimed an item 10(c) you would have to wait 9 complete. If you have You cannot claim an carried out an Item 10a Item 10b Item 10c Item 10a Item 10b Item 10c HISTORICAL CLAIM AND TIME-BAR PERIOD (normally 2 complete ) 9 complete 9 complete 9 complete 9 complete INFORMATION NOTES 1 Time-bar checks are carried out against a history for the same dentist. 2 3 The time-bars for item 10 are calculated based on the acceptance date of the historical claim to the completion date of the current claim. 4 Only one item 10 is payable per course of treatment. 5 Treatment under item 10 is inclusive of oral hygiene instruction, therefore a fee under item 6 cannot be claimed at the same time. 6 Item 10(a) is only payable in conjunction with an item 1(a), (b) or c) exam or where an exam was claimed within the previous 11 complete. 7 Item 10(b) is only payable in conjunction with an item 1(a), (b) or (c) exam or where an exam was claimed within the previous 11 complete. 8 Item 10(c) is only payable in conjunction with an item 1(c) exam or where an item 1 (c) exam was claimed within the previous 23 complete. 9 Item 10(c) - radiographs must be available and recorded as available on the claim. 11

JUNE 2014 COMBINATION CODES - GENERAL* DESCRIPTION COMBINATION OF REPAIRS REGISTERED OCCASIONAL UPPER Re-fixing a clasp + 1 fracture 2805 01 5505 01 31.05 Re-fixing a clasp + 2 fractures 2805 02 5505 02 37.05 Re-fixing a clasp + 3 or more fractures 2805 03-05 5505 03-05 39.45 LOWER Re-fixing a clasp + 1 fracture 2806 01 5506 01 31.00 Re-fixing a clasp + 2 fractures 2806 02 5506 02 37.00 Re-fixing a clasp + 3 or more fractures 2806 03-05 5506 03-05 39.45 MAXIMUM REPAIR PER DENTURE U / - - / L 2810 01 2820 01 5507 01 5508 01 39.45 39.45 COMBINATIONS OF ADDITIONS + REPAIRS 1 addition [clasp] with 1 repair [fracture] [balance fee**] 2880 01 2880 02 5560 01 5560 02 33.90 14.45 27.12 1 addition [tooth] with 1 repair [fracture] 2880 03 2880 04 5560 03 5560 04 17.25 1 addition [gum] with 1 repair [fracture] 2880 05 2880 06 5560 05 5560 06 17.25 1 addition [clasp] with 2 or more repairs [balance fee**] 2880 07 2880 08 5560 07 5560 08 33.90 14.45 27.12 1 addition [tooth] with 2 or more repairs [balance fee**] 2880 09 2880 10 5560 09 5560 10 19.85 1 addition [gum] with 2 or more repairs [balance fee**] 2880 11 2880 12 5560 11 5560 12 19.85 1 addition [clasp] with re-fix clasp [balance fee**] 2880 13 2880 14 5560 13 5560 14 33.90 14.45 27.12 1 addition [tooth] with re-fix clasp [balance fee**] 2880 15 2880 16 5560 15 5560 16 19.85 1 addition [gum] with re-fix clasp [balance fee**] 2880 17 2880 18 5560 17 5560 18 19.85 Any 2 additions with or without repairs - Fee 2880 19 5560 19 48.35 38.68 * Found in proviso for item 28/55 ** fee payable under item 28 and 55 is 48.35 Please note - no fee for impression can be paid with addition 12

DESCRIPTION JUNE 2014 COMBINATION CODES - ORTHODONTIC COMBINATION OF REPAIRS REGISTERED UPPER 32[C][2] + 1 repair under 32[C][1] 3252 01 40.45 32[C][2] + 2 or more repairs under 32[C][1] 3252 02 48.75 32[C][2] + 3 or more repairs under 32[C][1] 3252 03-05 49.10 LOWER 32[C][2] + 1 repair under 32[C][1] 3253 01 40.45 32[C][2] + 2 or more repairs under 32[C][1] 3253 02 48.75 32[C][2] + 3 or more repairs under 32[C][1] 3253 03-05 49.10 Please note - for item 32, the dentist must have fitted an appliance before any fee is payable. UPPER OCCASIONAL 55[E][2] + 1 repair under 55[E][1] 5593 01 40.45 55[E][2] + 2 or more repairs under 55[E][1] 5593 02 48.75 55[E][2] + 3 or more repairs under 55[E][1] 5593 03-05 49.10 LOWER 55[E][2] + 1 repair under 55[E][1] 5594 01 40.45 55[E][2] + 2 or more repairs under 55[E][1] 5594 02 48.75 55[E][2] + 3 or more repairs under 55[E][1] 5594 03-05 49.10 MAXIMUM REPAIR PER APPLIANCE U / - 3250 01 5595 01 49.10 - / L 3251 01 5596 01 49.10 13

CHANGES TO FREE REPAIR AND REPLACEMENT From 1 December 2012, a dentist cannot claim for repairing or replacing the following treatments when this happens within 11 complete of the original restoration by that dentist or another dentist acting on the dentist s behalf: Permanent fillings: Conservative treatment items 14 (a) - ( d ) and (f) - (j) Conservative treatment, special to minors, items 44 (a), (b) and (e) Occasional treatment items 58 (b) - (f) Occasional treatment, special to minors, item 60 (a) Root fillings: Items 15 (a) and (d) Inlays and Crowns: Items 17 (a) - (k) Bridges: Items 18 (a) - (h) Occasional treatment items 51 (d) and (e) A dentist could still claim however where the repair or replacement is as a result of trauma external to the mouth, as defined in Section I of the Statement of Dental Remuneration, and observations are clearly given in the claim. No patient charge applies if: It is within 12 months of the original treatment, and is like-for-like, and is subject to the following exclusions: - If private treatment has been applied; - Is intended to be temporary; - Is at the insistence of the patient, but against the advice of the dentist; - Another dentist has carried out occasional (other than temporary) treatment within 12 months, and it doesn t fall under the same dentist rule. - The dentist thinks restoring the tooth by repairing or replacing would not work, and that different treatment is needed; - It is due to trauma. Other conditions may apply, and we recommend you familiarise yourself with: NHS (General Dental Services)(Scotland) Regulations 2010 at : www.legislation.gov.uk/ssi/2010/208/contents/made?text=dental%20regulations MISCELLANEOUS INFORMATION patient charge - 384 Prior approval limit - 350 Payments will arrive in your bank account on the twentieth of each month (or the Friday before, if the twentieth falls on a weekend). GP17 paper claims Closing date for each schedule month (Example below is for June) Electronic Data Interchange (EDI) Last working day of schedule (30 June in this example) Seventh day of the following month (7 July in this example)* *Subject to change. Please check your broadcast messages. 14

Helpdesk Tel 0131 275 6300 Mon-Thurs 8.45am - 4.45pm & Fri 8.45am - 4.15pm or email nss.psddental@nhs.net When contacting Practitioner Services please quote your List Number. For Electronic Data Interchange (EDI) dentists, please quote your Location Number/Code.