Importing images

ItYou can import image files (.bmp, .png, .jpg, and .tiff files), CAD/CAM scan files (.sty and .ply files), and 3D volume files (.dcm files) to attach to a patient's record.

To import images

1. On the patient's record > Imaging tab, clicktap the Imaging tab menu and select Acquire Images.

   

   The first imaging procedure in your favorites list displays.

   Tip: Your favorites list should include your most frequently used imaging procedures. If it does not, we recommend you adjust your favorites.

   

   Note: If prompted with a Diagnostic Use Warning window, select the I accept the above-mentioned policy checkbox and clicktap Accept & Go to Imaging.

2. (Optional) If necessary, select a different imaging procedure.

   1. Under Imaging Procedures, clicktap one of the following tabs and select the procedure you want to perform.

      • Favorites - Displays a list of imaging procedures that you set as your favorite.

      • Standard - Displays a list of imaging procedures with standard imaging procedure codes from RCI.

      • Custom - Displays a list of imaging procedures with customized imaging procedures codes created by your organization's users.

      Note: Each procedure corresponds to an acquisition type: individual intraoral X-ray, intraoral X-ray series, extraoral X-ray, or intraoral photo, extraoral photo, CAD/CAM scan, or 3D volume.

      

3. Under Billing Options, set the following fields:

   • Apply charges: Select the checkbox if the fee for the selected procedure will be posted or deselect the checkbox a zero amount will be posted.

   • Bill to insurance: Select the checkbox if the patient's insurance carrier will be billed for the procedure.

   • Provider: Select the provider you want to associate with the procedure from the drop-down list.

     Tip: Only providers with access to the current location are available. The provider that is selected by default is determined by the current location's Default procedure provider setting.

4. Set the Acquisition Options as necessary for the type:

   Intraoral X-ray

   1. From the Tooth chart, select the teeth for the acquisition session.

      

      Tip: To deselect all teeth, clicktap Clear selected.

   2. (Optional) To allow for the automatic retaking of the radiograph until you have a satisfactory image, select the Enable auto-repeat checkbox.
      

      Note: If selected, only the last image is saved.

      Important: If you will be scanning a phosphor plate to acquire the image, ensure the Enable auto-repeat checkbox is not selected.

      

   3. Under Task to Perform, complete one of the following:

      • On the Acquire Images tab, select the Import From File device from the Available Devices menu.

        

      • On the Import Images tab, select one of the following radio buttons:

        • Existing Procedure - Select the radio button for a procedure that was performed prior to today (and may already have been billed to the patient's insurance carrier). Specify the date that the procedure was performed.

          Note: With this option selected, the Apply charges and Bill to insurance checkboxes under Billing Options become unavailable because the procedure will be posted with a zero dollar fee and will not be billed to insurance.

        • Completed Procedure - Select the radio button for a procedure that you are performing. Today's date and time will be associated with the procedure.

        

   Intraoral X-ray series

   1. If you are acquiring a series with two available sequences, under Acquisition sequence, complete one of the following:

      • To acquire a full mouth series, select the FMX 18 or FMX 21 radio button.

      • To acquire a 4-bitewing and 4-periapical series, select 4BW + 4PA or 4BW + 4PA Alt.

   2. Under Acquisition sequence, select Default sequence or a custom order.

   3. (Optional) To change the order of the acquisition sequence, clicktap each numbered box on the graphic in the order that you will acquire the images.

      

      Tips:

      • To undo the previous selection, clicktap Undo.

      • To undo all selections, clicktap Reset.

      • To save the custom sequence for future use, enter a name for the sequence, and select Save as ([sequence name]).

        

      • To delete a custom sequence, select the sequence, clicktap the Delete icon to turn it red, then clicktap the icon again.

   4. If no interpretation or analysis of the acquired images will be done in your office, to use the alternative procedure code for the selected imaging procedure, select the Without interpretation/analysis using code [code] checkbox.

   5. Under Task to Perform, complete one of the following:

      • On the Acquire Images tab, select the Import From File device from the Available Devices menu.

        

      • On the Import Images tab, select one of the following radio buttons:

        • Existing Procedure - Select the radio button for a procedure that was performed prior to today (and may already have been billed to the patient's insurance carrier). Specify the date that the procedure was performed.

          Note: With this option selected, the Apply charges and Bill to insurance checkboxes under Billing Options become unavailable because the procedure will be posted with a zero dollar fee and will not be billed to insurance.

        • Completed Procedure - Select the radio button for a procedure that you are performing. Today's date and time will be associated with the procedure.

        

   Extraoral X-ray

   1. If no interpretation or analysis of the acquired images will be done in your office, to use the alternative procedure code for the selected imaging procedure, select the Without interpretation/analysis using code [code] checkbox.

   2. Under Task to Perform, complete one of the following:

      • On the Acquire Images tab, select the Import From File device from the Available Devices menu.

        

      • On the Import Images tab, select one of the following radio buttons:

        • Existing Procedure - Select the radio button for a procedure that was performed prior to today (and may already have been billed to the patient's insurance carrier). Specify the date that the procedure was performed.

          Note: With this option selected, the Apply charges and Bill to insurance checkboxes under Billing Options become unavailable because the procedure will be posted with a zero dollar fee and will not be billed to insurance.

        • Completed Procedure - Select the radio button for a procedure that you are performing. Today's date and time will be associated with the procedure.

        

   Intraoral/extraoral photo

   1. If you are importing a set of intraoral or extraoral photos using a custom imaging procedure, under Acquisition sequence, select Default sequence or a custom order.

      

   2. (Optional) To change the order of the acquisition sequence, clicktap each numbered box on the graphic in the order that you will acquire the images.

      Tips:

      • To undo the previous selection, clicktap Undo.

      • To undo all selections, clicktap Reset.

      • To save the custom sequence for future use, enter a name for the sequence and select Save as ([sequence name]).

        

      • To delete a custom sequence, select the sequence, clicktap the Delete icon to turn it red, then clicktap the icon again.

   3. If no interpretation or analysis of the acquired images will be done in your office, to use the alternative procedure code for the selected imaging procedure, select the Without interpretation/analysis using code [code] checkbox.

   4. Under Task to Perform, complete one of the following:

      • On the Acquire Images tab, select the Import From File device from the Available Devices menu.

        

      • On the Import Images tab, select one of the following radio buttons:

        • Existing Procedure - Select the radio button for a procedure that was performed prior to today (and may already have been billed to the patient's insurance carrier). Specify the date that the procedure was performed.

          Note: With this option selected, the Apply charges and Bill to insurance checkboxes under Billing Options become unavailable because the procedure will be posted with a zero dollar fee and will not be billed to insurance.

        • Completed Procedure - Select the radio button for a procedure that you are performing. Today's date and time will be associated with the procedure.

        

   CAD/CAM Scan

   1. Under Task to Perform, complete one of the following:

      • On the Acquire Images tab, select the Import From File device from the Available Devices menu.

        

      • On the Import Images tab, select one of the following radio buttons:

        • Existing Procedure - Select the radio button for a procedure that was performed prior to today (and may already have been billed to the patient's insurance carrier). Specify the date that the procedure was performed.

          Note: With this option selected, the Apply charges and Bill to insurance checkboxes under Billing Options become unavailable because the procedure will be posted with a zero dollar fee and will not be billed to insurance.

        • Completed Procedure - Select the radio button for a procedure that you are performing. Today's date and time will be associated with the procedure.

        

   3D Image/Volume

   1. Select the Acquisition Type to determine which procedure is posted.

      

   2. For most acquisition types, the applicable teeth become selected automatically on the Tooth chart. For the other types, select the correct teeth (such as a sextant) by clickingtapping one of the applicable teeth or somewhere within the corresponding square bracket.

      Note: To deselect all selected teeth, clicktap Clear selected. It is available only if you have selected teeth manually.

      

   3. (Optional) If no interpretation or analysis of the acquired image will be done in your office, to use the alternative procedure code for the selected imaging procedure, select the Without interpretation/analysis checkbox.

      Note: The checkbox may not be available with every acquisition type.

   4. Under Task to Perform, complete one of the following:

      • On the Acquire Images tab, select the Import From File device from the Available Devices menu.

        

      • On the Import Images tab, select one of the following radio buttons:

        • Existing Procedure - Select the radio button for a procedure that was performed prior to today (and may already have been billed to the patient's insurance carrier). Specify the date that the procedure was performed.

          Note: With this option selected, the Apply charges and Bill to insurance checkboxes under Billing Options become unavailable because the procedure will be posted with a zero dollar fee and will not be billed to insurance.

        • Completed Procedure - Select the radio button for a procedure that you are performing. Today's date and time will be associated with the procedure.

        

5. ClickTap Proceed with Acquisition and import one or more images according to the acquisition type of the selected procedure.

   Intraoral X-ray

   1. When prompted with the Import File window, select the correct image file and clicktap Open.

      

      The image is saved to the patient's record.

      If you are importing in endo mode, the Import File window reopens. If not importing in endo mode, skip to Step 8.

   2. Repeat Steps a-b as needed to import additional images.
      

   3. When finished importing, clicktap Cancel to close the Import File window and clicktap Finish Acquisition.

   Intraoral X-ray series

   • If you selected the Import from File option on the Acquire Images tab in Step 4, complete the following:

     1. When prompted with the Import File window, select the correct image file and clicktap Open.

        

        The image is saved to the patient's record and a preview of the image displays. The program advances to the next step in the acquisition sequence automatically, and the Import File window re-opens.

        

        The current step in the acquisition sequence and the applicable teeth are selected for your reference.

        

     2. Repeat Steps a-b as needed to import additional images.
        

        Tip: To stop the acquisition session before you finish the entire series, clicktap Cancel to close the Import File window and clicktap Finish Acquisition. You can resume the incomplete exam later if necessary.

   • If you selected an option on the Import Images tab in Step 4, complete the following:

     1. ClickTap Start Importing.

        

     2. When prompted with the Import File window, select the correct image file and clicktap Open.

        

        The image that you imported displays as a thumbnail image on the panel at the bottom of Ascend Academic Imaging.

        

     3. Repeat Steps a-b as needed to import additional images.
        

        Tip: To stop the acquisition session before you finish the entire series, clicktap Cancel to close the Import File window and clicktap Finish Acquisition. You can resume the incomplete exam later if necessary.

     4. After all the images have been imported, drag the thumbnail images one at a time from the panel to the correct boxes of the template.
        

     5. If necessary, compete any of the following:
        

        • Stack multiple images in one template slot - Drag a thumbnail image from the panel or an image from a template slot to a template slot with an image assigned. That image is placed on top of the image stack for that template slot by default, but you can choose a different image to be on top.

        • Choose the top image for a template slot with multiple images - ClickTap the Next or Previous button as needed to navigate between the images in the stack. The image that is visible in the stack when you clicktap Begin Uploading will be set as the top image of the stack by default, but you can choose a different image to be on top later.

        • Change the orientation of an image in the template - Navigate to the correct image in the stack for a template slot (if multiple images are assigned to that template slot), select the image to view the toolbar, and clicktap any of the available buttons as needed: Flip Horizontal, Flip Vertical, Rotate Counterclockwise (90 degrees), and/or Rotate Clockwise (90 degrees).

        • Remove an image from the template - Navigate to the correct image in the stack for a template slot (if multiple images are assigned to that template slot) and drag the image back to the panel at the bottom.

     6. ClickTap Begin Uploading to save the mounted images to the patient's record.
        

        

     If not all thumbnail images have been mounted to the template when you clicktap Begin Uploading, a message displays, stating that unassigned images will not be saved to the patient's record.
     

     

     7. If prompted, clicktap one of the following buttons:

        • Send to Recovery - This saves the unassigned images. You can assign them to the patient later using the existing functionality for recovering images.

        • Discard Images - This deletes the unassigned images permanently.

        • Stay on Page - This allows the user to continue to assign unassigned images or make other changes without leaving the page.

     If any images fail to upload, a message displays and provides the option for you to recover the images. ClickTap Recover Images to begin the recovery process.

   Extraoral X-ray

   1. When prompted with the Import File window, select the correct image file and clicktap Open.

      

      The image is saved to the patient's record.

   Intraoral/extraoral photo

   • If you selected the Import from File option on the Acquire Images tab in Step 4, complete the following:

     1. When prompted with the Import File window, select the correct image file and clicktap Open.

        

        The image displays as a thumbnail image on the snapshot panel at the bottom of Ascend Academic Imaging.

        

     2. For each additional image that you want to import, clicktap Start Importing and repeat Step a.
        

        Tip: If necessary, deselect the checkbox of each snapshot you do not want to save You can resume the incomplete exam later if necessary.

     3. ClickTap Assign Images.
        

        Tip: To stop the acquisition session before you finish the entire series, clicktap Cancel to close the Import File window and clicktap Finish Acquisition. You can resume the incomplete exam later if necessary.

     4. Complete any of the following:
        

        • Save one or more snapshots as intraoral images and assign tooth numbers - Select and drag the snapshots that pertain to the same teeth to the Select Teeth, UR/UL/LR/LL, Upper Jaw, or Lower Jaw box.

          

          If you drag snapshots to the Select Teeth box, select the applicable teeth and clicktap Assign Teeth.

        • Save one or more snapshots as extraoral images - Select and drag the snapshots that are extraoral images to the Extraoral Photos box.

          

        • Save the snapshots as intraoral images without assigned tooth numbers - Leave the snapshots on the snapshot panel.

        Assigned intraoral images display on the left side of the preview area and extraoral display on the right.

        

        Note: If you have a mix of intraoral and extraoral images, they map to one procedure (D0350), which displays in the progress notes with two icons. Also, you can delete or reassign the intraoral or extraoral exam as needed in the future.

     5. ClickTap Begin Uploading to save the images to the patient's record.
        

     If any images fail to upload, a message displays and provides the option for you to recover the images. ClickTap Recover Images to begin the recovery process.

   • If you selected an option on the Import Images tab in Step 4, complete the following:

     1. When prompted with the Import File window, select the correct image file and clicktap Open.

        

        The image that you imported displays as a thumbnail image on the panel at the bottom of Ascend Academic Imaging.

        

     2. For each additional image that you want to import, clicktap Start Importing and repeat Step a.
        

     3. After all the images have been imported, drag the thumbnail images one at a time from the panel to the correct boxes of the template.
        

     4. ClickTap Assign Images.
        

        Tip: To stop the acquisition session before you finish the entire series, clicktap Cancel to close the Import File window and clicktap Finish Acquisition. You can resume the incomplete exam later if necessary.

     5. Complete any of the following:
        

        • Save one or more snapshots as intraoral images and assign tooth numbers - Select and drag the snapshots that pertain to the same teeth to the Select Teeth, UR/UL/LR/LL, Upper Jaw, or Lower Jaw box.

          

          If you drag snapshots to the Select Teeth box, select the applicable teeth and clicktap Assign Teeth.

        • Save one or more snapshots as extraoral images - Select and drag the snapshots that are extraoral images to the Extraoral Photos box.

          

        • Save the snapshots as intraoral images without assigned tooth numbers - Leave the snapshots on the snapshot panel.

        Assigned intraoral images display on the left side of the preview area and extraoral display on the right.

        

        Note: If you have a mix of intraoral and extraoral images, they map to one procedure (D0350), which displays in the progress notes with two icons. Also, you can delete or reassign the intraoral or extraoral exam as needed in the future.

     6. ClickTap Begin Uploading to save the images to the patient's record.
        

     If any images fail to upload, a message displays and provides the option for you to recover the images. ClickTap Recover Images to begin the recovery process.

   Set of Photos

   • If you selected the Import from File option on the Acquire Images tab in Step 4, the first step in the acquisition sequence is selected automatically (as indicated by the green, numbered box) on the sequence diagram, and the applicable teeth are selected on the Tooth status chart for your reference.

     

     1. When prompted with the Import File window, select the correct image file and clicktap Open.

        

        The image is saved to the patient's record, and a preview of the image displays. Also, if the image that you just acquired was not for the last step in the acquisition sequence, the next step is selected automatically (as indicated by the green, numbered box) on the sequence diagram, and the applicable teeth are selected on the Tooth status chart for your reference.

        

     2. For each additional image that you want to import, repeat Step a.
        

        Tip: To stop the acquisition session before you finish the entire series, clicktap Cancel to close the Import File window and clicktap Finish Acquisition. You can resume the incomplete exam later if necessary.

   • If you selected an option on the Import Images tab in Step 4, complete the following:

     1. ClickTap Start Importing.

        

     2. When prompted with the Import File window, select the correct image file and clicktap Open.

        

        The image that you imported displays as a thumbnail image on the panel at the bottom of Ascend Academic Imaging.

        

     3. For each additional image that you want to import, repeat Steps a-b.
        

     4. After all the images have been imported, drag the thumbnail images one at a time from the panel to the correct boxes of the template.
        

     5. If necessary, compete any of the following:
        

        • Stack multiple images in one template slot - Drag a thumbnail image from the panel or an image from a template slot to a template slot with an image assigned. That image is placed on top of the image stack for that template slot by default, but you can choose a different image to be on top.

        • Choose the top image for a template slot with multiple images - ClickTap the Next or Previous button as needed to navigate between the images in the stack. The image that is visible in the stack when you clicktap Begin Uploading will be set as the top image of the stack by default, but you can choose a different image to be on top later.

        • Change the orientation of an image in the template - Navigate to the correct image in the stack for a template slot (if multiple images are assigned to that template slot), select the image to view the toolbar, and clicktap any of the available buttons as needed: Flip Horizontal, Flip Vertical, Rotate Counterclockwise (90 degrees), and/or Rotate Clockwise (90 degrees).

        • Remove an image from the template - Navigate to the correct image in the stack for a template slot (if multiple images are assigned to that template slot) and drag the image back to the panel at the bottom.

     6. ClickTap Begin Uploading to save the mounted images to the patient's record.
        

        

     If not all thumbnail images have been mounted to the template when you clicktap Begin Uploading, a message displays, stating that unassigned images will not be saved to the patient's record.
     

     

     7. If prompted, clicktap one of the following buttons:

        • Send to Recovery - This saves the unassigned images. You can assign them to the patient later using the existing functionality for recovering images.

        • Discard Images - This deletes the unassigned images permanently.

        • Stay on Page - This allows the user to continue to assign unassigned images or make other changes without leaving the page.

     If any images fail to upload, a message displays and provides the option for you to recover the images. ClickTap Recover Images to begin the recovery process.

   CAD/CAM Scan

   1. When prompted with the Import File window, select the correct image file and clicktap Open.

      

   2. When prompted with the Set Model Orientation window, adjust the orientation of the model as you want it to display in Ascend Academic Imaging:
      

      

      • Select the yellow circle to make it active, and then drag to rotate the model clockwise or counterclockwise.

        

      • Select the green line to make it active, and then drag to rotate the model on the x-axis.

        

      • Select the red line to make it active, and then drag to rotate the model on the y-axis.

        

      • ClickTap anywhere within the purple circle to make it and the yellow circle active, and then drag to move the model in any direction.

        

      Note: When you save the orientation, that view of the model becomes the default you can adjust it further from within Ascend Academic Imaging later on.

   3. ClickTap Save.
      

   The image is saved to the patient's record.
   

   3D Image/Volume

   1. When prompted with the Import File window, select the correct image file and clicktap Open.

      Without DICOM support

      

      With DICOM support

      

   The image is saved to the patient's record.
   

6. If necessary, complete one of the following:

   • Assign tooth numbers to a series of X-ray images or individual X-ray image.

     1. Under Image Navigator, clicktap an image thumbnail.

        A larger version of the current image displays in the viewing area.

        

     2. ClickTap the Edit icon to display the Assign Tooth Numbers window.

        

     3. To change dentition, clicktap Toggle primary/permanent to display a tooth chart and the dentition buttons, select the applicable teeth, and clicktap the Permanent or Primary button. Repeat as needed to change the dentition of other teeth, then clicktap Back to assignment.

        

     4. Select the applicable tooth numbers.

     5. ClickTap Assign Teeth.

   • Assign tooth numbers to a set of photos or an individual photo.

     1. Under Image Navigator, clicktap an image thumbnail.

        A larger version of the current image displays in the viewing area.

        

     2. ClickTap the Edit icon to display the Assign Tooth Numbers window.

        

     3. To change dentition, clicktap Toggle primary/permanent to display a tooth chart and the dentition buttons, select the applicable teeth, and clicktap the Permanent or Primary button. Repeat as needed to change the dentition of other teeth, then clicktap Back to assignment.

        

     4. Select the applicable tooth numbers.

     5. ClickTap Assign Teeth.

   • Assign tooth numbers to a CAD/CAM scan.

     1. ClickTap the Edit icon to display the Assign Tooth Numbers window.

        

     2. To change dentition, clicktap Toggle primary/permanent to display a tooth chart and the dentition buttons, select the applicable teeth, and clicktap the Permanent or Primary button. Repeat as needed to change the dentition of other teeth, then clicktap Back to assignment.

        

     3. Select the applicable tooth numbers.

     4. ClickTap Assign Teeth.

   • Change the assigned tooth numbers for a 3D image or volume.

     1. ClickTap the Edit icon to display the Assign Tooth Numbers window.

        

     2. To change dentition, clicktap Toggle primary/permanent to display a tooth chart and the dentition buttons, select the applicable teeth, and clicktap the Permanent or Primary button. Repeat as needed to change the dentition of other teeth, then clicktap Back to assignment.

        

     3. Select the applicable tooth numbers.

     4. ClickTap Assign Teeth.