Editing procedures

When necessary, you can edit a procedure. This can include linking conditions to a procedure to help reduce the number of rejected insurance claims due to missing condition codes.

Depending on their stage, procedures are available from different pages:

• Progress Notes or Treatment Planner: Allows you to review planned, completed, or existing procedures.

• Ledger: Allows you to review completed procedures.

Note: You cannot edit a procedure if it is locked, attached to an insurance claim, associated with a rejected treatment plan, or a payment has already been posted for it.

Tips:

• If locked, you can unlock and edit a locked procedure.

• If an insurance payment has already been posted, you can void the procedure, re-post it correctly, and post an offsetting adjustment.

Important: To edit a completed procedure, you must have the Edit completed procedure Bill to insurance and the Edit completed procedures security rights. If you only have the Edit completed procedure Bill to insurance security right, you can only manage the Bill to Insurance toggle on completed procedures.

To edit a procedure

1. Complete one of the following:

   • Open a patient's record > Progress Notes tab.

     

   • Open a patient's record > Treatment Planner tab and select a treatment plan.

     

   • Open a patient's Ledger page.

     

2. Select a procedure to display the Edit Procedure window.

   

   Note: If the procedure is locked, the View Procedure window displays instead. You can unlock it to edit.

3. Edit the procedure details as necessary.

   • Transaction date - Select the date of service. Leave the current date entered, or clicktap in the field to select a different date. However, you cannot backdate a procedure to a date that would cause it to become locked based on your organization's transaction lock setting.

   • Provider - By default, Ascend Academic automatically assigns a provider based on the following scenarios:

     • If you are a provider, you are assigned as the provider.

     • If you are not a provider, the patient's primary provider is set as the provider.

     • If you and the patient's primary provider are not a provider, the first provider on the list is assigned as the provider.

     If necessary, you can assign a different provider.

   • Status - From the drop-down list, select a completed, treatment-planned, or existing procedure.

     Note: If you require approval to complete or post a procedure, you cannot change the status from Tx Plan to Completed until approval has been given.

   • Procedure - ClickTap in the field, enter the code or description of the appropriate procedure, and select the procedure to post. If necessary, enter the supporting treatment information, such as a tooth number and surfaces.

   • Bill to insurance - Set whether the selected procedure should be billed to insurance. If the toggle is set to On, the procedure can display on a claim. If the toggle is set to Off, the procedure cannot be added to a claim and will not be included in estimated insurance portion calculations.

     Note: The default state of this toggle is determined by the setup of the procedure code. Use caution when turning on this option for an alias procedure code or a non-standard code because some carriers may reject this procedure on a claim or may reject the entire claim due to the presence of an unrecognized procedure code.

   • Amount - Set the charge for the selected procedure. The amount displays automatically, but you can change it if necessary.

     Note: By default, this amount is determined by the following method: first, if the patient has insurance coverage, there is a fee schedule attached to that insurance plan, the selected procedure exists on that fee schedule, and the provider is contracted with that carrier, the amount comes from the selected procedure on that contracted fee schedule; next, if the selected provider has a fee schedule and the selected procedure exists on that fee schedule, the amount comes from the selected procedure on that provider's fee schedule; then, if none of the previous criteria have been met, the amount comes from the procedure code list. Additionally, if the patient has a discount fee schedule and does not have insurance coverage, the amount shown will be posted to the patient's ledger, but an adjustment will be entered automatically for the difference between the charged amount and the amount for the procedure on the patient's discount fee schedule.

   • Teeth, Surfaces, and so forth - If applicable for the selected procedure, specify the supporting treatment information, such as Tooth, Tooth Ranges, and/or Surfaces.

     Notes:

     • For the Tooth box, to change the tooth number to a supernumerary tooth number, do the following:

       • For a permanent tooth, add 50 (for example, 16 + 50 = 66).

       • For a primary tooth, add a letter "s" (for example, CS).

     • For the Tooth Ranges box (which is available only for a periapical imaging procedure), you can specify or change the tooth ranges:

       • Enter the first and last tooth numbers of a range separated by a dash.

       • Enter an individual tooth number.

       • Enter a combination of ranges and/or individual tooth numbers, separating each with a comma.

       

   • Note: To change the tooth number to a supernumerary tooth number, complete the following: for a permanent tooth, add 50 (for example, 16 + 50 = 66); for a primary tooth, add a letter "s" (for example, CS).

   • Note - Enter any relevant notes regarding the procedure. The maximum length allowed for the note is 255 characters.

   • Update procedure code/amount to the recommended value above? - Complete any of the following:

     • If the selected Procedure is not valid for the specified tooth number and/or treatment areas (such as surfaces), the recommended ADA Procedure Code displays next to the field. To use the recommended procedure, either clicktap the recommendation to insert that value into the Procedure field, or select the Update procedure code/amount to the recommended value above? check box to use the recommended value automatically when you save the procedure.To not use the recommended procedure, clear the Update procedure code/amount to the recommended value above? check box.

     • If the Amount entered is different than the fee for the selected procedure in the patient's discount fee schedule (if applicable) or the provider's fee schedule (or if not applicable, the default fee for the procedure code), the recommended amount displays next to the field. To use the recommended amount, either clicktap the recommendation to insert that value into the Amount field, or select the Update procedure code/amount to the recommended value above? check box to use the recommended value automatically when you save the procedure. To not use the recommended amount, clear the Update procedure code/amount to the recommended value above? check box.

     • If there are recommendations for both the Procedure and the Amount, but you want to use only one of those recommendations, clicktap the recommendation that you want to use, and then clear the Update procedure code/amount to the recommended value above? check box before saving the procedure.

     

4. From the Options tab, edit the fields as necessary.

   • Require Start/Completion Dates - If the procedure requires a start and completion date, select the Require start/completion dates check box and set the date the procedure was started and will be completed in the Start and Completion fields.

     Note: The dates default to today.

   • Orthodontic Treatment - If applicable, select the Orthodontic Treatment check box, set the date that the orthodontic device was placed in the Placement field, and set the number of months that remain until the treatment is complete in the Month Remaining field.

     Notes: 

     • These options are only available if an orthodontic procedure is selected and has a Completed status.

     • When you create a claim for the procedure, the total number of months will be calculated (based on the placement date and remaining months) and entered on the claim automatically.

5. From the Insurance Estimates tab, edit the following fields as necessary.

   • Outstanding Insurance Estimates - Ascend Academic automatically calculates the estimated primary and secondary insurance portions, write-off, and guarantor portion for each procedure. If necessary, you can turn off the automatic calculation and modify the the estimated primary and secondary insurance portions and write-off.

   • Insurance Estimate Overrides - Select the Primary and/or Secondary check box and enter an amount that differs from the estimated amount that insurance will pay for primary coverage and/or secondary coverage.

     Important: The amount of the primary or secondary estimate, or the sum of both estimates, cannot exceed the amount being charged for the procedure.

6. From the Diagnosis tab, attach any necessary diagnosis codes.

   1. In the search box, enter part of a condition's ICD-10 code, SNOMED code, or description to search for a condition that has been charted for the patient.

   2. Select the correct diagnosis.

      Note: You can attach up to 20 diagnostic codes to the procedure.

      

7. ClickTap Save.

   Important: If you edited a procedure's code, tooth, surfaces, class, and/or amount, and the procedure is associated with a treatment plan case that was approved by faculty, you are prompted to have faculty with the security rights to approve treatment plan procedure updates authorize the change by entering their credentials. Once authorized, the associated treatment plan case's status updates to Pending Patient Consent and the change is recorded in the case's history.