Hi, i've lost track of SNOMED, is this still waiting to be updated on R4, is this something I need to add manually, I've checked previous posts and can't find any other information on this other than the one in August about waiting for the SNOMED codes...
I thought it was easier to continue this thread rather than create a new one as it's linked on from here, can I confirm that the Clinical Data Sets in R4 are putting "fissure sealant with composite" down as a band 2 restoration, and that there are associated codes with it that won't get rejected by the DPB?
When I've looked at a patient whom we have completed a band 2 fissure sealant with composite on, although it is generating a band 2 on R4 the clinical data set remains as (1) rather than (2), i'm presuming this is indicative of what band this treatment falls under and therefore may be rejected or only 1 UDA received instead of 3?
I've attached a snip of what I mean, I've got the document from the Dental Practice Board and I can see the code for fissure sealants is 9303 band 1 and permanent fillings is 9306, should fissure sealant with composite on R4 fall under 9306 code to generate the correct clinical data set?
Thanks for your help,
Just to provide some more clarity..
The CDS Banding represents the new Validation the board is performing on Submitted claims so there are occasions they won't match but it also won't be a problem unless a reject occurs, the information shown is simply a point of Reference for Situtations where Claims are Rejected on the Basis of Banding Mismatches so you can pinpoint what the board are saying is the mismatch in the Claims data. Other than where a rejection warrants it you can simply ignore it in most cases.
There was a change affecting Sealant Restorations for Wales recently that might be playing a part here, Can you post the actual DPB Code charted for your Fissure Sealant with Composite?, basically under CDS Rules any Treatment not recognised under a specific group defaults to Other to indicate that something was completed outside of the groups called out so that is not unexpected based on your screenshot.
Many thanks for your post.
The CDS banding tab has been designed with the requirements sent over from the board, the type of code setup is what triggers which item is ticked within this tab.
It isn't linked to the charge banding and wont amend the charge banding, the claim will be paid correctly for the 3UDA's regardless of the CDS tab.
Many thanks for your post, apologies for the delay I was chasing for updates on SNOMED.
We are in regular contact with the BSA but no further information has been given. Below is the thread with the latest, as soon as we have anything further we will update this post.
Thanks for the update Matt. I'm not sure if this is related to SNOMED, on the BSA website there is information about CDS Items and treatment bands. There is a list of codes that BSA have advised are mandatory from 1st April or the claims will be rejected, is this linked to SNOMED? How can we get the codes updated on R4, is this something in practice has to sort out or is this something linked to the codes on R4? The link is here: https://www.nhsbsa.nhs.uk/activity-payment-and-pension-services/dental-activity-processing under "Completion of forms"
This isn't related to SNOMED, if your practice is based in Wales an update is due out shortly to include the changes required from 1st April.
We will be in touch as soon as the update has been assigned to your download portal.
OK. We are based in England not Wales, however slightly concerned that the form is under "England", we won't see the claims from 1st April being rejected will we as it states if the claims don't have these codes on the claims will fail/be rejected- doesn't specify this is for Wales only.
It wont be a requirement for England from 1st April, however the v8.1.11 will be available on every sites portal. If you check your portal later this week it should be available for yourself to download and run.
Thank you for this, we ran the update on 31st March, I can see the claims created on 31st March that we did not send to the DPB yet and are sending this morning do not have the CDS attached to it, whereas the patients we are seeing today with April dates on have the new CDS codes on, does this mean that the claims from March which we are sending today will likely be rejected as R4 hasn't assigned the CDS codes to them?