NQF NULL: Children Who Have Dental Decay or Cavities

Measure: Record the percentage of children, age 0-20 years, who have had tooth decay or cavities during the measurement period.
Numerator: All children who meet the denominator criteria and had cavities or decayed teeth.
Denominator: All children, age 0-20 years, with a visit during the measurement period.
Exclusion:  None
NQS Domain: Clinical Process / Effectiveness

In ChartMaker Clinical:

In order to qualify for this measure, the provider must have seen the patient at least one time during the reporting period and have the appropriate information documented in the chart:

Required Data Elements for the Denominator*:

• Office Visit or Face-to-Face Encounter Code during the measurement period
Valid Office Encounter Codes:
CPT:  
Code Description
99201 Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 10 minutes are spent face-to-face with the patient and/or family.
99202 Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low to moderate severity. Typically, 20 minutes are spent face-to-face with the patient and/or family.
99203 Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A detailed history; A detailed examination; Medical decision making of low complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate severity. Typically, 30 minutes are spent face-to-face with the patient and/or family.
99204 Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 45 minutes are spent face-to-face with the patient and/or family.
99205 Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 60 minutes are spent face-to-face with the patient and/or family.
99212 Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 10 minutes are spent face-to-face with the patient and/or family.
99213 Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: An expanded problem focused history; An expanded problem focused examination; Medical decision making of low complexity. Counseling and coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low to moderate severity. Typically, 15 minutes are spent face-to-face with the patient and/or family.
99214 Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A detailed history; A detailed examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 25 minutes are spent face-to-face with the patient and/or family.
99215 Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 40 minutes are spent face-to-face with the patient and/or family.
99381 Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; infant (age younger than 1 year)
99382 Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; early childhood (age 1 through 4 years)
99383 Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; late childhood (age 5 through 11 years)
99384 Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; adolescent (age 12 through 17 years)
99385 Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 18-39 years
99386 Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 40-64 years
99387 Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 65 years and older
99391 Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; infant (age younger than 1 year)
99392 Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; early childhood (age 1 through 4 years)
99393 Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; late childhood (age 5 through 11 years)
99394 Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; adolescent (age 12 through 17 years)
99395 Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 18-39 years
99396 Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 40-64 years
99397 Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 65 years and older
Valid Face-to-Face Encounter Codes:
SNOMED:  
Code Description
4525004 Emergency department patient visit (procedure)
12843005 Subsequent hospital visit by physician (procedure)
18170008 Subsequent nursing facility visit (procedure)
19681004 Nursing evaluation of patient and report (procedure)
87790002 Follow-up inpatient consultation visit (procedure)
90526000 Initial evaluation and management of healthy individual (procedure)
185349003 Encounter for "check-up" (procedure)
185463005 Visit out of hours (procedure)
185465003 Weekend visit (procedure)
207195004 History and physical examination with evaluation and management of nursing facility patient (procedure)
270427003 Patient-initiated encounter (procedure)
270430005 Provider-initiated encounter (procedure)
308335008 Patient encounter procedure (procedure)
390906007 Follow-up encounter (procedure)
406547006 Urgent follow-up (procedure)
439708006 Home visit (procedure)

Required Data Elements for the Numerator*:

• Dental Caries Diagnosis Code (with attached SNOMED) that occurs before or during (and does not end prior to the start of) the measurement period
ICD-9:   
Code Description
521 Dental caries, unspecified
521.01 Dental caries limited to enamel
521.02 Dental caries extending into dentine
521.03 Dental caries extending into pulp
521.04 Arrested dental caries
521.05 Odontoclasia
521.06 Dental caries pit and fissure
521.07 Dental caries of smooth surface
521.08 Dental caries of root surface
521.09 Other dental caries
ICD-10:  
Code Description
K02.3 Arrested dental caries
K02.51 Dental caries on pit and fissure surface limited to enamel
K02.52 Dental caries on pit and fissure surface penetrating into dentin
K02.53 Dental caries on pit and fissure surface penetrating into pulp
K02.61 Dental caries on smooth surface limited to enamel
K02.62 Dental caries on smooth surface penetrating into dentin
K02.63 Dental caries on smooth surface penetrating into pulp
K02.7 Dental root caries
K02.9 Dental caries, unspecified
SNOMED:
Code Description
5170009 Complex dental caries (disorder)
15733007 Incipient enamel caries (disorder)
30512007 Cementum caries (disorder)
80353004 Enamel caries (disorder)
80753001 Arrested dental caries (disorder)
80967001 Dental caries (disorder)
95246007 Salivary dysfunction caries secondary to aging (disorder)
95247003 Salivary dysfunction caries secondary to medication (disorder)
95248008 Salivary dysfunction caries secondary to radiation therapy (disorder)
95249000 Salivary dysfunction dental caries (disorder)
95252008 Secondary dental caries associated with failed or defective dental restoration (disorder)
95253003 Secondary dental caries associated with local or systemic factors (disorder)
95254009 Secondary dental caries (disorder)
109564008 Dental caries associated with enamel hypomineralization (disorder)
109566005 Dental caries associated with enamel hypoplasia (disorder)
109568006 Dental caries secondary to developmental defects of tooth structure (disorder)
109569003 Dental caries secondary to acquired defects of tooth structure (disorder)
109571003 Primary dental caries, indeterminate origin (disorder)
109572005 Primary dental caries, cervical origin (disorder)
109573000 Primary dental caries, proximal smooth surface origin (disorder)
109574006 Primary dental caries, nonproximal smooth surface origin (disorder)
109575007 Primary dental caries, pit and fissure origin (disorder)
109576008 Primary dental caries, root surface origin (disorder)
109577004 Primary dental caries, multisurface origin (disorder)
109578009 Caries of infancy (disorder)
109579001 Caries of infancy, indeterminate origin (disorder)
109580003 Caries of infancy associated with breast feeding (disorder)
109581004 Caries of infancy associated with bottle feeding (disorder)
163152009 On examination - dental caries (disorder)
196298000 Acute dentine dental caries (disorder)
196299008 Chronic dentine dental caries (disorder)
196301001 Acute enamel dental caries (disorder)
196302008 Chronic enamel dental caries (disorder)
196305005 Odontoclasia (disorder)
234976000 Rampant dental caries (disorder)
442231009 Caries involving multiple surfaces of tooth (disorder)
442551007 Dental caries extending into dentine (disorder)

EXCLUSION DETAILS:

There are no exclusions for this measure.

 

*ADDITIONAL INFORMATION:

•  The patient must be under 20 years of age prior to the start of the measurement period

•  The only data used to determine the denominator is data from the ChartMaker Clinical Module. If a patient encounter was not entered into the ChartMaker Clinical Module, that encounter is not included in the denominator for the statistical calculations on the Meaningful Use Dashboard. Please add these additional patients to the denominator and recalculate the percentage for Attestation purposes.

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