CMS74v11 – Primary Caries Prevention Intervention as Offered by Primary Care Providers, including Dentists

Children, 6 months – 20 years of age, with a visit during the measurement period

– NUMERATOR

Children who receive a fluoride varnish application during the measurement period

–Denominator Exclusions

Exclude patients who are in hospice care for any part of the measurement period

For Denominator:

All patients aged 6 months – 20 years, with a qualifying encounter during the measurement year. To record an encounter, navigate to Patient > Provider Note > eSuperbill. Under the ‘Procedure- CPTs’ heading, enter the encounter code.

• Office Visit
• Clinical Oral Evaluation
• Online Assessments
• Telephone Visits
• Preventive Care Services – Initial Office Visit, 18 and Up
• Preventive Care Services – Established Office Visit, 18 and Up
• Preventive Care – Initial Office Visit, 0 to 17
• Preventive Care – Established Office Visit, 0 to 17

For Numerator:

Include patients with a ‘Flouride Varnish Application for Children’ procedure performed during the measurement year. To record the procedure, navigate to Patient > Provider Notes > Orders > Procedure. Click ‘Add’ and search for the procedure. Add the procedure details and click on ‘Save & Accept’/hover over ‘Sign & Accept’. If the user hover over ‘Sign & Accept’, then click ‘Complete’. The procedure is added to the provider note.

Note:

Please ensure that the Procedure is present in the system. For this, navigate to Settings > Billing > Procedure. If the procedure is not added then, click on the ‘Add Procedure’ button. 

Here, enter the ‘Code’ and ‘Name’ of the Procedure. Once done, click on the ‘Save’ button. 

For Denominator Exclusions: 

Exclude patients who received hospice care during the measurement year. To document that patient is receiving hospice care outside of a hospital or long term care facility, navigate to Patient > Clinical > Evaluations. Use the below mentioned codes to order or perform an intervention:

• 385763009: Hospice Care (Regime/Therapy)
• 385765002: Hospice Care Management (Procedure)

• To document an encounter inpatient, navigate to Patient > Clinical > Evaluations