CMS74v13 – Primary Caries Prevention Intervention as Offered by Dentists

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

The clinical oral evaluation should exist as an encounter.

– NUMERATOR

Children who receive two fluoride varnish applications on different days during the measurement period.

–Denominator Exclusions

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

For Denominator:

To record an encounter, navigate to Patient > Provider Note > Create Superbill. Under the ‘Procedure- CPTs’ heading, enter the relevant encounter code.

For Numerator:

To record the procedure for fluoride varnish application, navigate to Patient > Provider Note > Orders > Procedures. Click ‘Add’ and search for the relevant procedure. Add the procedure details and click on ‘Save & Accept’ or ‘Sign & Accept’.

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.