Weigh-in on proposed dental rule change; get details on new OHCA dental code and more!

Proposed dental rule change; new OHCA dental code in effect; Provider Training dates; Dental Health Month resources and more!

Having trouble viewing this email? View it as a Web page.

Oklahoma Health Care Authority Dental Checkup

Winter 2017

Dental rule on list of proposed changes for 2017

Policy word in vintage metal

One dental rule concerning diagnostic casts (WF# 16-34 ) is under consideration in the 2017 OHCA permanent rulemaking session. Permanent rule recommendations go to the Legislature and Governor for action in the spring.  

Proposed revisions add language to allow dental providers the option to submit the diagnostic cast or photographic images as evidence of medical necessity for dental services. The procedure is a necessary part of many dental practices, including orthodontics, and the change allows providers to bill for a necessary service. 

WF# 16-34 is available for comment at www.okhca.org/PolicyBlog. The comment period closes Feb. 17, 2017. We encourage you to review this and other OHCA proposed rules and give your input. 

As required by state statute, OHCA provides a Rule Impact Summary for each proposed rule, which includes projected budget impacts.

Back to top 

Dental Checkup Doctor's Note

Doctor, do you know the Systematized Nomenclature of Dentistry?

Dr. Leon Bragg, OHCA chief dental officer

Systematized Nomenclature of Dentistry (SNODENT) is a vocabulary designed by the American Dental Association (ADA) for use in electronic health and dental records (EHR and EDR, respectively).  

Initial development of SNODENT began more than 10 years ago. Developed specifically for use with EHRs, SNODENT allows for the capture and analysis of detailed oral health data. You may have noticed that claim forms have a box for diagnosis codes. Now you know the rest of the story.  

According to the ADA, the intended purpose of SNODENT is to:

provide standardized terms for describing dental disease

capture clinical detail and patient characteristics

permit analysis of patient care services and outcomes

be interoperable with EHR and EDR 

better communication among dentists and other health care providers 

improve patient care through evidence-based practices

enhance data collection for the evaluation of oral care outcomes 

The ADA reports that SNODENT enables clinicians to record finely-detailed oral health data in a manner that is on par with our medical colleagues. Eligible dental practitioners who participate in Medicaid may be required to use SNODENT, as SNOMED-CT is the required terminology for certified EHRs.

EHR systems certified under meaningful use Stage 2 criteria can already support use of SNOMED. The ADA is developing a crosswalk from SNODENT to ICD-10 CM.  SoonerCare Dental has already provided a targeted list of ICD-10 codes for your education on our website, under “Commonly Used Forms.” 

While some dentists may see this advance as “intervention,” it is apparent that diagnosis codes and value-based dental services are near. Dentistry must keep pace with changes, and practitioners should accept this future or be left behind. 

More information about SNODENT is available on the ADA website.

Dr. Leon Bragg
Chief Dental Officer

Back to top

Chew on this!

February is National Children's Dental Health Month and is a great time for all children to have their teeth examined, whether they are covered by SoonerCare, are underinsured ... or have no dental insurance at all. 

Below are some community resources to help get it done!

OkMOM event offers free dental services, needs volunteers

Dentist works on mature man's teeth

Get ready for the Oklahoma Mission of Mercy (OkMOM) event, Feb. 3-4, 2017, at the Woodward County Fairgrounds & Event Center. OkMOM is a two-day, FREE dental clinic for adults and children who are either uninsured, under-insured or would normally not have access to dental care. No-cost dental screenings help these patients identify their needs and determine a treatment plan. 

This annual event provides dental care to as many people as time, volunteers and supplies will allow. To learn how to volunteer, donate or for more information, please visit OkMOM online at http://www.okmom.org/

Since 2010, OkMOM has treated 12,175 patients, totaling $8,742,959 in donated dental care.

This event is endorsed by the Oklahoma State Department of Health.

Uninsured kids get free dental checkups in OK County

Good Shepherd Ministries offers dental and medical care to the uninsured. Dental services tailored specifically for children are available each week, and a number of these timeslots go unfilled.

The Good Shepherd Ministries’ Kids Clinic occurs on Tuesday evenings during the school year . The clinic is located at 222 NW 12th Street in Oklahoma City, at the corner of 12th and Harvey. Volunteer dental students and faculty from OU College of Dentistry provide dental treatment at no charge for any dentally uninsured child with an appointment. 

For more information or to schedule an appointment, please call 405-232-8631.

Back to top

Dental Checkup For the record

New OHCA dental code in effect

The American Dental Association (ADA) Code Maintenance Committee has approved 11 new codes for 2017. The new codes will appear in the CDT 2017 Dental Procedure Codes. Among the 11 new codes is D1575, distal shoe space maintainer - fixed-unilateral. The distal shoe has previously been reported as D1510 - space maintainer - fixed-unilateral, which also describes the band and loop space maintainer. 

The distal shoe space maintainer is indicated when there is early loss of a primary second molar before the eruption of the first permanent molar. It serves to guide the unerupted permanent first molar into position, preventing mesial movement of the permanent first molar after premature loss or extraction of the second primary molar. OHCA began covering D1575 for our pediatric members on Jan. 1, 2017, and will be reimbursed the same as D1510.

Back to top

    Save the date: 2017 Spring Provider Training Workshops

    Puzzle pieces form the word "Training"

    You and your staff are invited to attend the spring 2017 SoonerCare Provider Training Workshops hosted by OHCA and HP Enterprise Services.

    • Lawton - April 13
    • Durant - April 27
    • Tulsa - May 17 - 18
    • OKC - May 24 - 25
    • Guymon - June 21  

    OHCA and HP highly recommend that all providers attend this workshop. Be sure to mark your calendar! 

    We will release class descriptions, recommended audiences and registration details soon. Please visit the provider training page of our website for updates.

    Back to top

    Historic moment for oral health

    Smile America 1

    Many children have a fear of going to the dentist, but being in a dentist’s office was the norm for young Debra Bartlett, now a staff member in the Member Services department at OHCA.

    Debra’s father, Leo Phis Webster, was a dental hygienist at Scott Air Force Base in Illinois.

    One day, in the mid-1970s, there was a call for two children to help promote a Dental Health Week. Mr. Bartlett selected his daughter to participate, allowing her to be part of a photo opportunity with the base commander. This simple turn of events would impact American children for decades to come.

    “I was one of the first kids to have my teeth sealed,” Debra said. “It was part of a pilot program, so they can [sic] track us and see how well the sealants worked.”

    Smile America 2, with Debra Bartlett

    It was an important moment in the early movement for better dental health in the United States. According to Leo Webster, Dental Health Week was a big thing for the base every year.

    “We’d go out to the schools and educate the kids on dental hygiene,” Leo said. “Being that I was so involved with it, they wanted someone to highlight [the week] in the local news media. So, I chose my daughter and my coworker’s son.”

    Prior to this time, there was not much instruction available on how to care for teeth. Studies showed that if you taught people how to brush and care for their teeth, it saved them money on dental care and lead to better oral health overall, Leo said. The field was called “preventive dentistry” at that time.

    Leo Webster retired after 24 years in the Air Force and now resides in Oklahoma City.

    Back to top

    Dental Checkup Provider Toolkit

    OHCA Provider Helpline: 800-522-0114

    Dental Prior Authorization Unit: 405-522-7401

    Provider Resources

    Web Alerts

    Online Training

    OHCA will be closed Feb. 20, 2017

    Dental Checkup Statement

    Information contained within is subject to change. Be sure to check OHCA Provider LettersGlobal Messages and Web Alerts at www.okhca.org for the most up-to-date information.

    Word of mouth banner

    Here are a few hot topics in dentistry:

    Order Publications

    OHCA Calendar

    Newsletter Archive 

    Dental Checkup At the root

    Answers to your frequently asked questions

    1.    How will I know about changes to SoonerCare policies and rules?

    OHCA provides policy and program information in several ways:

    • Global Messages 
    • Provider Letters
    • SoonerCare Fax Blasts
    • Web Alerts

    You may also choose to bookmark the following page, which is a one-stop-shop for many of the above updates and more: http://www.okhca.org/provider-updates

    Additionally, OHCA also communicates these changes through the secure Provider Portal and our provider newsletters.

    2.    A dental claim was denied that I believe should have been paid.  What must I do to have the claim reviewed?

    Please fill out an HCA-17 and mail it to the address on the form. Be sure to include any radiographs, clinical notes and/or other documentation to support payment. The HCA-17 form is available at http://www.okhca.org/forms.

    3.    Where can I find information about SoonerCare Dental? 

    The OHCA public website has a dental providers’ page that covers policy, fees, prior authorization, commonly used forms and other helpful information:  http://www.okhca.org/dental-providers.   

    TSET-OHCA Soonerquit Women-Kristi-F