CMS74v12 – Primary Caries Prevention Intervention as Offered by Dentists

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 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.

• Clinical Oral Evaluation

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

• 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.