Acquiring intraoral and extraoral photos

You can acquire intraoral and extraoral photos with digital cameras and third-party programs.

Notes:

For the complete list of acquisition devices supported by Ascend Academic Imaging, see Supported imaging acquisition devices.
If the acquisition stops at any point because of a device error, you can fix the issue and clicktap Start to proceed with the acquisition.

Important:

The acquisition agent must be installed before you can acquire images. If prompted with an Acquisition Activation window, you must clicktap the Click here link to begin downloading the acquisition agent installer.
The first time that you attempt to use a camera with Ascend Academic Imaging on any computer, you must give permission when a message from the browser displays and asks if you want to allow the browser to have access to the camera.

To acquire intraoral and extraoral photos

How to get there

From the Patient menu, under Clinical, select Imaging.

The patient record displays with the Imaging tab selected.

Tip: You can also access imaging from other clinical areas such as Chart, Progress Notes, Quick Exam, Perio, or Tx Planner.

Note: If the correct patient is not already selected, use the Patient Search field to access the patient's record.

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.
(Optional) If necessary, select a different imaging procedure that corresponds to the acquisition type for intraoral and extraoral photos (such as 2D Oral/Facial Photo Images).
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.
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.
- Select Provider: Select the provider you want to associate with the procedure from the drop-down list.
Set the Acquisition Options for intraoral and extraoral photos.
1. 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 sequence in the order that you will acquire the images.
  Tips:
  - To undo previous order selections, clicktap Undo as needed.
  - To undo all order 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 acquiring intraoral or extraoral photos using a standard imaging procedure and no interpretation or analysis of the acquired image will be done in your office, select the Without interpretation/analysis using code D0703 checkbox to use an alternative procedure code.
4. Under Task to Perform, clicktap the Acquire Images tab to review the devices installed and configured on the computer.
5. If necessary, click the arrow button and select the correct device.
ClickTap Proceed with Acquisition and complete the acquisition process for one or more intraoral and/or extraoral photos using your selected device.

Individual images with a camera
1. Review the live video stream as it displays on your camera.
  Tips:
  - To tune your camera's settings, clicktap the Tune Camera icon.
  - To change the acquisition device, clicktap the Available Devices for Procedure arrow and select an option.
2. Point the camera at the patient or at the correct area inside the patient's mouth.
3. With the camera properly positioned, use the button on your camera to pause the live video stream or clicktap Pause Streaming.
4. Use the button on your camera to capture the current video frame or clicktap Take a snapshot.
  
  The resulting image is added to the snapshot panel and the video stream becomes live again.
5. Repeat Steps c - d as necessary to acquire additional snapshots.
6. (Optional) On the snapshot panel, deselect the checkbox for each snapshot you do not want.
7. ClickTap Assign Images.
8. To save the snapshots, complete any of the following:
  - To save one or more snapshots as intraoral images and assign tooth numbers, select and drag the snapshots related to the same teeth to the Select Teeth, UR/UL/LR/LL, Upper Jaw, or Lower Jaw box.
    
    Note: If you drag the snapshots to the Select Teeth box, select the applicable teeth and clicktap Assign Teeth.
  - To save one or more snapshots as extraoral images, select and drag the snapshots to the Extraoral Photos box.
  - To save the snapshots as intraoral images but not assign tooth numbers, leave those snapshots on the snapshot panel.
  Assigned intraoral images display on the left side of the preview area, assigned extraoral images display on the right, and images without assigned tooth numbers (which will be saved as intraoral images) display on the snapshot panel.
  
  Note: If you have a mix of intraoral and extraoral images, they map to one procedure (D0350), which will appear in the progress notes with two icons. You can delete or reassign the intraoral or extraoral exam as needed in the future.
9. ClickTap Begin Uploading to save the images to the patient's record.
Individual images with a third-party program (TWAIN or bridge)
1. Use the options in the third-party TWAIN interface or imaging program that opens to get ready to acquire the image.
2. Use the camera to capture images of the patient or the correct areas inside the patient's mouth.
3. Close the third-party TWAIN interface or imaging program.
  
  The images that you captured in the third-party program display as thumbnail images in the snapshot panel at the bottom of the imaging program.
4. Complete any of the following as necessary:
  - To save one or more snapshots as intraoral images and assign tooth numbers, select and drag the snapshots related to the same teeth to the Select Teeth, UR/UL/LR/LL, Upper Jaw, or Lower Jaw box.
    
    Note: If you drag the snapshots to the Select Teeth box, select the applicable teeth and clicktap Assign Teeth.
  - To save one or more snapshots as extraoral images, select and drag the snapshots to the Extraoral Photos box.
  - To save the snapshots as intraoral images but not assign tooth numbers, leave those snapshots on the snapshot panel.
  Assigned intraoral images display on the left side of the preview area, assigned extraoral images display on the right, and images without assigned tooth numbers (which will be saved as intraoral images) display on the snapshot panel.
  
  Note: If you have a mix of intraoral and extraoral images, they map to one procedure (D0350), which will appear in the progress notes with two icons. 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.
Set of images with a camera (applicable only for a custom imaging procedure)
1. Review the live video stream as it displays on your camera.
  Tips:
  - To tune your camera's settings, clicktap the Tune Camera icon.
  - If you need to change the acquisition device, clicktap Pause, select a different device on the Available Devices for Procedure menu, and clicktap Discard to resume the acquisition.
  - To skip ahead in the acquisition sequence one step, clicktap Skip Forward. This button is available only if the current step in the sequence is not the last step.
  - To go backward in the acquisition sequence one step, clicktap Skip Backward. This button is available only if the current step in the sequence is not the first step, and if the previous step in the sequence does not have an image.
2. Point the camera at the patient or at the correct area inside the patient's mouth.
3. With the camera properly positioned, use the button on your camera to pause the live video stream or clicktap Pause Streaming.
4. Use the button on your camera to capture the current video frame or clicktap Save.
5. If you acquired an image for a step in the acquisition sequence that already has an image, the Select Image window displays. Keep the Delete rejected image checkbox deselected to have the rejected image hidden or select the checkbox to have the rejected image be deleted. Then clicktap Keep New to keep the recaptured image and put it on the top of the image stack for the template slot or Keep Old to keep the existing image and leave it on the top of the image stack for the template slot.
  
  The resulting image displays. Also, if the image that you just acquired was not for the last step in the acquisition sequence, the next step in the acquisition sequence is selected automatically (as indicated by the green, numbered box) on the sequence diagram, the applicable teeth are selected on the Tooth status chart for your reference, and the video stream automatically becomes live again.
  Tips:
  - To stop the acquisition session before you finish acquiring the entire set, clicktap Finish Acquisition. You can resume the incomplete exam later if necessary.
  - To replace an image that you have just acquired, clicktap Skip Backward to navigate to the previous step. With the camera properly positioned, clicktap Pause to pause the video stream and clicktap Save to capture the current video frame. The Select Image window displays. Keep the Delete rejected image checkbox deselected to have the rejected image hidden or select the checkbox to have the rejected image be deleted. Then clicktap Keep New to keep the recaptured image and put it on the top of the image stack for the template slot or Keep Old to keep the existing image and leave it on the top of the image stack for the template slot. You can repeat this process as needed until you have acquired a satisfactory image.
  - To skip ahead in the acquisition sequence one step, clicktap Skip Forward. This button is available only if the current step in the sequence is not the last step.
  - To go backward in the acquisition sequence one step, clicktap Skip Backward. This button is available only if the current step in the sequence is not the first step, and if the previous step in the sequence does not have an image.
6. Repeat Steps a-e until you finish acquiring images for the set.
Series of images with a third-party program (TWAIN or bridge)
1. Use the options in the third-party TWAIN interface or imaging program that opens to get ready to acquire images.
2. Use the camera to capture images of the patient or the correct areas inside the patient's mouth.
3. Close the third-party TWAIN interface or imaging program.
  
  The images that you captured in the third-party program display as thumbnail images in the snapshot panel at the bottom of the imaging program.
4. Drag the snapshots from the panel to the correct template boxes.
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.

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