A question we often receive is how to determine the billing for codes that are time based. The most common inquiry is how to bill scaling codes, especially since the dental hygiene appointment incurs numerous tasks.
Following the guidelines of the Ontario Dental Association (ODA) and the College of Dental Hygienist in Ontario (CDHO), we have created a summary for reference.
First, it is important to understand the definitions of “appointment time” and “treatment time.” Appointment time procedures are not included in the number of units reported. They are generally procedures that incur during every appointment. On the other hand, treatment time can be added to the time units if the treatment is directly related to the procedure.
How to Determine Scaling Code
Appointment time includes multiple processes. Appointments are scheduled according to the time required for all the processes to be completed. For the dental hygienist, these processes can include:
· Patient rapport
· Patients concerns and/or complaints
· Medical history updates
· Radiograph processing and interpretation
· Pocket measurements
· Caries Checks
· Treatment notes (including notes not specific to scaling)
· Tasks related to infection control such as donning PPE
· Operatory set-up and breakdown
The costs associated with the above “appointment time” tasks were taken into consideration when preparing the suggested fee schedule. Appointment time procedures are not added to treatment time units. This means that appointment time procedures are not added as units of time to scaling and/or root planing.
Treatment time begins when the practitioner prepares to deliver the procedures, and ends when the procedure is completed. For the dental hygienist performing scaling procedures, the treatment time can include:
· Reviewing the patients chart to confirm there are no contraindications to perform procedures
· Pre and post antimicrobial rinsing
· Administrating topical and/or local anaesthetic
· Performing the scaling
· Providing postoperative instruction
· Documenting the scaling in the chart
· Documenting the scaling post treatment instructions
Treatment time for the above is included in scaling time. For example:
Treatment: Treatment Time
Reviewing chart,
administration of local anaesthetic,
providing post-op instruction,
documenting scaling findings. 10 minutes
Scaling 35 minutes
Total Treatment Time 45 minutes
Procedure Code to Chart: 11113 (3 Units of Scale= 45 minutes)
In summary, time spent on procedures that are required in order to scale, or as a result of scaling are added to the number of minutes used to calculate the treatment time. Any procedures done during the appointment time that are not specific to scaling cannot be calculated into treatment time.
To help you calculate scaling units, we've created a "cheat sheet" that we'll send your way. Just send us an email to info@rna180.com with "Scaling Units" in the subject line.
With RNA 180, you take the guesswork out of calculating scaling units.. We do the calculations for you, so you bill scaling units correctly, every time. Click the "Let's Chat: button below and we'll show you how.
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