CMS75v12 – Children Who Have Dental Decay or Cavities

Children, 1 – 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 (Dental Caries) in any part of the measurement period.

–Denominator Exclusions

Patients who are in hospice care for any part of the measurement period.

For Denominator:

To record a clinical oral evaluation encounter, navigate to Patient > Provider Note > Create Superbill. Under the ‘Procedure- CPTs’ heading, enter the encounter code.

For Numerator:

The documentation of ‘Dental Caries’ diagnosis can be done via Patient > Provider Note > Diagnoses. Here, click ‘Add’ and search for any relevant diagnosis. Fill out the diagnosis details as needed and click ‘Save’. Then click ‘Accept’ to add the diagnosis to the provider note.

For Denominator Exclusions:

• To document that a patient is receiving hospice care outside of a hospital or long-term care facility, navigate to Patient > Provider Note > 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 inpatient encounter, navigate to Patient > Provider Note > Evaluations.

• To document a hospice care assessment, follow the workflow Patient > Provider Note > Evaluations. Click ‘Add’ and search for ‘Hospice Care [Minimum Data Set]’. Then select ‘Performed’ from the ‘Status’ dropdown and ‘Yes’ from the ‘Result’ field.

• A hospice encounter can be documented through Patient > Provider Note > Evaluations or Patient > Provider Note > Create Superbill.