1. RPMS DDS Package Training Day 2

2. Basic Skills Review Hollister

3. Data Entry Review Implications for reports –Sometimes required by administration –Good for QA tracking (post-surg. complications, etc.) –Useful in clinical productivity analysis, efficiency, QI tracking (BA rates), and making a case for additional staff Implications for billing –Coding correctly prevents “unbundling” or “overcoding” –We’ll be teaching common coding errors later today

4. Tracking Disease Status IH Codes –Removed from RPMS in 2008 –Now must use local codes: –Subsets of patients IH33 – WIC IH34 – Patients enrolled in special programs 0004 – Head Start –Caries Risk IH40 – Low Risk (no caries experience, good oral hygiene) IH41 – Moderate Risk (caries experience, none active) IH42 – High Risk (active caries) IH43 – Very High Risk (>6 teeth with active caries)

5. Tracking Disease Status More IH Codes –Caries Prevalence IH44 – caries free (no caries experience) IH45 – untreated decay (active caries) IH46 – neither code applies (caries experience) –Periodontal Disease IH47 – patient with acceptable perio health IH48 – high risk perio patient (1 “4” on CPITN) –Other codes of importance 0007 – dental sealant present, no sealant indicated

6. Tracking Disease Status Caries Risk –Can be used to track high-risk patients –Must be entered to be tracked Caries Prevalence –Can be used to determine caries prevalence (IH44/(IH44+IH45+IH46) or untreated decay rates (IH45/(IH44+IH45+IH46) –Must be entered always to be tracked & be accurate Periodontal Disease Risk –Can be used to track high-risk patients (recall management) Sealants –0007 will be used in GPRA Year 2011, so get used to using it now –Proportion of children aged 6-15 with either a 1351 or 0007/# of children aged 6-15

7. Reports Hollister

8. Tracking Procedure Codes GPRA Measures Access to Care Sealants Patients Receiving Topical Fluorides Remember that the DDS package is not exact – it does not take into account patients the GPRA user population

9. Tracking Procedure Codes GPRA –For Fiscal Year 2008, how many patients received fluoride? How many fluoride applications were there? –We will be counting patients, not codes (option 1 at the end) –Answer: 5 patients; 18 applications Now, your turn…

10. Tracking Procedure Codes How many patients received topical fluoride applications in GPRA Year 2007? GPRA Year: July 1, 2006 – June 30, 2007 Codes: 1203, 1204, 1206

11. Tracking Procedure Codes How many patients received topical fluoride applications in GPRA Year 2007? –18 GPRA Year: July 1, 2006 – June 30, 2007 Codes: 1203, 1204, 1206,

12. Tracking Procedure Codes How many topical fluoride applications were there in GPRA Year 2007? GPRA Year: July 1, 2006 – June 30, 2007 Codes: 1203, 1204, 1206

13. Tracking Procedure Codes How many topical fluoride applications were there in GPRA Year 2007? –21 GPRA Year: July 1, 2006 – June 30, 2007 Codes: 1203, 1204, 1206

14. Tracking Procedure Codes You can also use QMAN to check on patients receiving fluoride (if medical is applying them) –Go to QMAN –Condition 1: Dx (diagnosis) V07.31 Between July 1, 2006 and June 30, 2007 –Count “hits” (option 3) –This provides patients with medical fluoride; does not take into account which ones have also received it in dental (but gives you an idea if medical is doing them).

15. Tracking Procedure Codes See attached “How to Track GPRA” document

16. Tracking Procedure Codes Let’s see what you’ve learned on tracking codes… 1. How many comprehensive exams (0150) were done in the Sells Service Unit in calendar year 2007? 2. How many of these exams were conducted on children 12 years and younger?

17. Tracking Procedure Codes 1.How many comprehensive exams (0150) were done in the Sells Service Unit in calendar year 2007? 19 2.How many of these exams were conducted on children 12 years and younger? 12

18. Tracking Procedure Codes Post-surgical complications –Using SCOM, how many extractions were done between Jan. 1, 2006 and Dec. 31, 2008? Use codes 7140 and 7210. –How many post-surgical complications were there in this same time period? Use code 9930. –What was the post-surgical complication rate?

19. Tracking Procedure Codes Post-surgical complications –Using SCOM, how many extractions were done between Jan. 1, 2006 and Dec. 31, 2008? 75 –How many post-surgical complications were there in this same time period? 10 –What was the post-surgical complication rate? 10/75, or 13%

20. Tracking Procedure Codes Figuring out a broken appointment rate –Use SCOM for this (although DANN can be used as well) –Count codes 0000, 0190, 9130, and 0140 or 9170 (whichever is used routinely for emergency encounters) –Example

21. Tracking Procedure Codes Now your turn… –For FY 2006, what is the broken appointment rate?

22. Tracking Procedure Codes Now your turn… –For FY 2007, what is the broken appointment rate? First, count the codes for 10/1/06 – 9/30/07 0000: 61 0190: 134 9130: 0 0140: 24 So the BA rate is 0/(61+134+0-24) = 0%

23. Tracking Procedure Codes You can use SCOM to show follow-up codes For example, let’s look at the number of perio patients recalled within a year. –Under the “Followed By”, type in “Y” instead of pressing enter –Type in the follow-up code (example: 4910) –Type in the days you want to see if the follow- up code applies (example: 365 days)

24. Common Coding Mistakes Hollister

25. Patient Education You can track and get credit for patient education by putting it into PCC in addition to DDS (1310, 1320, and 1330) ►For dental, only 4 codes have currently been developed: ☺DC = dental caries ☺PD = periodontal disease ☺ECC = early childhood caries ☺TO = tobacco

26. Steps for Documenting Patient Ed *5 Mandatory steps, 3 Optional steps 1.* Disease state, illness, condition or system being addressed 2.*Specific education topic 3.Readiness to learn 4.*Level of patient/family understanding of the material 5.*Time spent by the provider who did the education 6.*Initials of the provider who did the education 7.Goal setting 8.Comments

27. Patient Education Example Chart 200001 Dental Visit 10/24/07 First, do the dental data visit (you can have two RPMS screens open, one for PCC and one for DDS) Go to APP visit (to append dental visit) Enter “PED” for patient education Enter “T” (topic) of “DC” (dental caries) Find “Prevention” and enter the corresponding # (11) Readiness to Learn – either “??” to get choices or just press enter (not a required element) Level of Understanding – required; type “go” (good) Provider – type “Ricks” (required element) Length of education – type “15” minutes (minimum for it to “count”) “^” to get out of the system REMEMBER – for it to be entered, it must be DOCUMENTED!