CMS75v11 – Children Who Have Dental Decay or Cavities

Children Who Have Dental Decay or Cavities CMS 75v11 Percentage of children, 6 months – 20 years of age at the start of the measurement period, who have had tooth decay or cavities during the measurement period as determined by a dentist
DENOMINATOR

Children, 6 months – 20 years of age at the start of the measurement period, with a clinical oral evaluation by a dentist during the measurement period

NUMERATOR

Children who had a diagnosis of cavities or decayed teeth in any part of the measurement period

Denominator Exclusions

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

APPLICATION WORKFLOW

For Denominator:

All patients aged 6 months – 20 years at the start of the measurement period, 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.

  • Clinical Oral Evaluation
eSuperbill

For Numerator:

Include patients with ‘Dental Caries’ diagnosis during the measurement year. To record the ‘Dental Caries’ diagnosis, use the workflow Patient > Provider Note > Diagnoses, and click ‘Add’. Search for the ‘Dental Caries’ diagnosis, add the diagnosis details and click ‘Save’. Then click ‘Accept’ and the diagnosis is added to the provider note.

‘Dental Caries’ Diagnosis

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)
Evaluation
  • To document an encounter inpatient, navigate to Patient > Clinical > Evaluations 
Evaluation
  • Patients with hospice care assessment performed during the measurement period. To document the assessment, follow the workflow Patient > Clinical > Evaluations. Click ‘+ Add’ and search for an evaluation. Then select ‘Performed’ from the ‘Status’ dropdown and enter ‘Yes’ in the ‘Result’ field.
  • Patients with hospice encounter during the measurement period. To document the hospice encounter, follow the workflow Patient > Clinical > Evaluations.