Prototype Transmission Specification
Version: V1.0
Valid from 01/10/2015
Prototype Transmission Specification (26 May 2015) v1.0 1 Document Control
Version Date Changed By Summary of Changes
0.1 draft Prototype version 1.0 to reflect Dental Contract Reform Programme requirements for prototype contracts 0.1 draft Section 2 has been completely revised to provide a more detailed background of the rationale for the Prototypes and detail of the preventative care pathway
0.1 draft All new items from V3 of the Dental Contract Pilots transmission Specification are shown in red. All data items removed have been greyed out
0.2 draft Feedback from individual supplier calls have been included All new items from V3 of the Dental Contract Pilots transmission Specification are shown in red. All data items removed prior to the creation of this document have been struck through and all data items removed as part of the introduction of the Prototypes and been struck through and greyed out Changes to business rule numbers 0.3 draft 1 May 2015 James Viles Amended following Programme review Distribution list to reflect changes in Personnel References to document are changed to refer to current version rather than the specific document version number Review of business rules throughout the document, primarily involving the addition of BRs relating to private data collection Correction of typos Addition of three new data items privateindirectcrowns, privateindirectother, privateextraction
0.4 draft 19 May 2015 James Viles Addition of dummy value for performer number where treatment provided by performer without NHS performer number
Prototype Transmission Specification (26 May 2015) v1.0 2 1.0 26 May 2015 James Viles Baselined
Prototype Transmission Specification (26 May 2015) v1.0 3 Approval
Name Role/Title Date Version Signature
Peter Howitt Head of Dentistry and Eye Care Services
Distribution
Version Date Distribution List
1.0 DH - Peter Howitt, Helen MisCampbell, Hamid Butt, Jennifer Forester, David Glover, Keith Ellis NHS England – Serbjit Kaur NHS Dental Services – Ruth Gasser, James Viles, Chris Chester, Darren Williams, Richard Kiernan, Rav SinghDarren Boelema Dental System Suppliers – Carestream, Dentsys, Pearl, SfD, Software of Excellence
Prototype Transmission Specification (26 May 2015) v1.0 4 1 Contents 1 Contents...... 4
2 Background...... 6
2.1 Preventive Care Pathway...... 6
2.1.1 Matrices...... 6
2.1.2 Social and medical history...... 7
2.1.3 Oral health review...... 8
2.1.4 Preventive care and treatment...... 8
2.1.5 Patient self-care plan...... 9
2.2 Dental Quality and Outcomes Framework (DQOF)...... 10
2.3 Activity...... 10
2.4 Capitation...... 10
2.5 Patient charges and payments...... 11
2.6 FP17 and Appointment (care pathway) Data Transmissions...... 11
2.6.1 FP17s...... 11
2.6.2 Appointment (Care Pathway) data...... 11
3 Process Data Sets...... 13
3.1 Practice/Performer Details...... 14
Prototype Transmission Specification (26 May 2015) v1.0 5 3.2 Patient Details...... 14
3.3 Appointment Details...... 20
3.4 Oral Health Assessment...... 26
3.4.1 Current Problems...... 29
3.4.2 Tooth Assessments...... 30
3.4.3 Mouth Level Data...... 41
3.4.4 Sextant Section...... 42
3.4.5 Risk Screening...... 47
3.4.6 Treatment Plan...... 57
3.4.7 Advanced Care...... 59
3.5 Treatment and Clinical Dataset for Prototypes...... 62
3.5.1 Clinical Dataset Items...... 63
3.5.2 Referral...... 74
Prototype Transmission Specification (26 May 2015) v1.0 6 2 Background The Department of Health announced on 15 January 2015 the next stage of the programme to reform primary care dentistry. A limited number of dental practices will start prototyping a possible new contractual system from autumn 2015. The prototypes will use the same clinical pathway and capitation and quality framework as the pilots with some refinements and modifications. Unlike the existing dental pilots, prototype contracts will include an element of activity (UDAs) as well as capitation and quality. The full proposals are set out in https://www.gov.uk/government/publications/dental-reform-next-step . The inclusion of activity does not require a change to the software specification as all the information required for this new element of remuneration is already provided through the existing FP17 returns.
A key change in prototypes will be the requirement for participating contractors to provide data in relation to all private treatment given to an NHS patient except for cosmetic only items such as external bleaching, or other treatments not available under NHS regulations, such as implants. This will be subject to appropriate patient consent. Currently the requirement for pilots is to provide data in relation to private treatment delivered within a mixed private /NHS CoT. So, this would mean that for example, where a patient attends for a scale and polish on a private basis between NHS CoTs data would be required to be submitted. The software transmission specification is labelled V1.0 to mark the fact that the prototypes are a new and distinct stage of contract reform. However, with the exception of the change to the collection of private data, the software transmission specification and business rules are broadly similar to the V3 specification used for the pilot contracts. For ease of reference for existing suppliers already working with the programme the previous pilot requirements dropped prior to version PRO V1 are still shown, but struckthrough, requirements dropped from V3 of Pilots are struckthrough and greyed out and any new items are highlighted through track changes.
2.1 Preventive Care Pathway Patients treated under capitation arrangements (all patients except those who only receive an urgent course of treatment or patients for whom only particular elements of care are provided on referral) will be provided with a structured oral health assessment which assesses their risk of dental disease across four key dental disease areas or clinical domains:
Caries
Periodontal disease
Soft tissue disease
Tooth surface loss
Prototype Transmission Specification (26 May 2015) v1.0 7 2.1.1 Matrices
This structured oral health assessment considers risk in relation to each clinical domain separately using elements of the clinical examination as well as patient factors determined from the social and medical history obtained for the patient. Based on these findings a series of matrices generates a red, amber, or green rating for each disease area together with suggested preventive actions for the patient and actions for the dental team to minimise that risk as far as possible. The matrices for each clinical domain, the relevant clinical and patient factors, risk ratings and suggested dental and team actions are detailed in the current version document Risk Matrices Prototypes V23022015, which suppliers are advised to refer to. Where a practitioner wishes to amend the risk rating for any clinical domain they should be able to do so. For example a patient may be amber for a particular clinical domain based on medical history factors, but the practitioner may feel based on their clinical judgment that if the patient has been with the practice some time and is quite stable there is no significantly increased risk and they may wish to amend the risk rating to green.
For patients as specified below the following domains are mandatory:
1. Children under 3 years of age – caries
2. Children aged 3-6 years of age – caries, perio and soft tissue
3. Edentate patients – soft tissue
For all other patient groups it is mandatory to complete all four clinical domains, unless the patient is non-compliant for any reason and examination of that area is not possible when the OHA/OHR should be marked as such for the relevant domain.
For existing pilot suppliers the only change to the matrices for prototypes is the amendment of the suggested OHR interval for patients with a red risk of periodontal disease from 9 months to 12 months.
2.1.2 Social and medical history
The matrices identify particular social history and medical history factors required to enable the matrices to function and the relevant questions are specified in the current version of documents Medical History for Prototypes V1.0 and Social History for Prototypes V1.0, which suppliers are advised to refer to. It should be emphasised that these are not designed to be a complete MH and SH to meet all care requirements, but simply to enable the preventive care pathway matrices to function and practitioners may wish to and should be able to add to these forms as they consider appropriate. Answers to the specified questions are not mandated and so should a patient decline to answer a social history question it should be possible for the system user to move on without answering the question. The matrices should generate a risk rating for any given clinical domain based on the information entered. Prototype Transmission Specification (26 May 2015) v1.0 8 The programme required social history aims to group questions to specific groups of patients however; systems should not prevent practitioners from asking additional questions where they consider this to be appropriate. For example, alcohol and smoking questions are included within the questions for adults, but practitioners are likely to wish to ask adolescents the same questions, where it is deemed appropriate to do so. However, systems are not required to take account of any responses that are not specified within the published matrices for a particular age group.
For existing pilot suppliers there are no changes to either the medical history or social history questions for prototypes.
2.1.3 Oral health review
The level of risk for each disease area will suggest an appropriate interval for a further oral health review (OHR). Where suggested oral health review intervals are different for different clinical domains, the shortest interval suggested by the matrices should be provided. So, for example where for periodontal disease the level of risk suggests an OHR of 12 months, but the risk for caries suggests an OHR at 6 months then the suggested OHR interval should be 6 months. The suggested system generated oral health review should be based on the matrices. Where a practitioner has amended the patient risk rating (RAG) they may also need to amend the OHR interval accordingly.
2.1.4 Preventive care and treatment
In some instances in addition to the oral health review, intervals for preventive treatments are suggested by the matrices, which the practitioner may consider to be appropriate. This would be for preventive items such as the twice yearly application of topical fluoride varnish for child patients. While a child patient may have a low risk of developing caries (green) with a suggested OHR of 12 months, Delivering Better Oral Health (DBOH) would still recommend they are likely to benefit from twice yearly application of fluoride varnish. A fluoride application at 6 months would be provided as an additional preventive CoT. Prototypes, like existing pilots are able to provide specific items of care and treatment under regulations without any requirement to provide a banded CoT and re-assessment of oral health. Where such items are required the practitioner would determine this at the OHA / OHR and they would be planned accordingly as a separate preventive CoT as part of the patient’s care. The preventive items of treatment are contained in the current version of document, Interim Care 3800 codes Prototype 140203, which lists relevant treatment codes that suppliers are advised to refer to.
For existing suppliers there are no changes to these treatment items.
Prototype Transmission Specification (26 May 2015) v1.0 9 2.1.5 Patient self-care plan
The Programme has provided a template for the self-care plan to be used by the prototypes. Patient actions suggested by the matrices should auto-map to the self-care plan. In order to keep the list of codes reasonably concise they have been kept reasonably generic and the template includes additional space for free text for more patient specific guidance practitioners may wish to provide, for example with regard to oral hygiene instruction. Suppliers are advised to refer to the current version of the self-care plan documents: Self Care Plan Protoypes v1.0 and Patient Action Codes Mapping to Self Care Plan v1.0
Prototype Transmission Specification (26 May 2015) v1.0 10 2.2 Dental Quality and Outcomes Framework (DQOF) An element of prototype contract value will be based on performance against quality measures across several areas:
1 Clinical effectiveness
2 Patient experience
3 Patient safety
4 Data Quality
In addition to the metrics used for pilots examining the quality of work and clinical outcomes achieved, prototypes will include a number of metrics that measure elements of process.
Clinical effectiveness outcome measures will rely on pairings of oral health assessments and oral health reviews and these measures are similar to those used by the pilots. So, for example measure 01.05 looks at the percentage of adult patients with a BPE score of 2 or more with sextant bleeding sites improved at the next OHR. This measure would look at the BPE at OHA/OHR and when the patient next attends for OHR compare the number of sextants where bleeding is recorded with the number recorded at the previous assessment. Other clinical effectiveness action measures look at percentages of patients who receive particular preventive measures such as fluoride varnish or tooth brushing instruction. Compliance with NICE guidance on recall indicators will also be assessed for patients in different risk groups.
Patient experience measures are assessed using patient questionnaires sent to a sample of patients selected from monthly scheduled FP17s.
The patient safety measure uses information on the proportion of patients for whom the medical history is reviewed and updated at OHR and this uses information from the transmitted data for the OHA/OHR.
Data quality indicators are based on the timeliness of both FP17 and appointment transmissions.
2.3 Activity Prototype contractors will have a required level of clinical activity (UDAs) they are required to deliver during the year. Activity will be calculated using scheduled FP17s. For prototypes activity will apply for either band 3, or band 2 and 3 activity for capitation patients and will be adjusted to reflect elements of care that have been included in capitation payments. For other categories of patients there will not be any adjustment to UDAs, which will be calculated in the usual way. NHSBSA will calculate and report adjusted UDAs based on prototype FP17 transmissions.
Prototype Transmission Specification (26 May 2015) v1.0 11 2.4 Capitation Within prototypes capitation payments will cover either band 1 or band 1 and 2 treatment, depending on the type of prototype contract. The trigger for a new capitation interval will be an OHA/OHR. Patients requesting urgent care only as well as patients seen for treatment on referral (who are not referred for all care including an OHA) will not be included in capitation. NHSBSA will process and report capitation lists / patient numbers using transmitted appointment (care pathway) and FP17 data.
2.5 Patient charges and payments Prototypes will continue to be paid by 12 equal monthly instalments based on their contract value, with any appropriate adjustments for performance (capitation, activity and DQOF) being made following year end. Patient charges will continue to be deducted in the usual way based on FP17 transmissions. The FP17 transmission process will continue unchanged at this stage as transmission of appointment (care pathway) data for prototypes will not be directly linked to NHSBSA payment system.
2.6 FP17 and Appointment (care pathway) Data Transmissions 2.6.1 FP17s
As stated in 1.5 above FP17s should be transmitted in the usual way for all CoTs and submitted at the end of a CoT. The only difference between prototype and non-prototype contracts is that prototypes, like pilots are permitted to submit an FP17 for a preventive CoT defined as in accordance with band 1a in regulations. This is submitted as band 1 where a patient charge would apply (if appropriate) and as band 5 (NHSBSA definition of band 1a) where the band 1a (for which no charge would be made) CoT would be a charge exempt CoT in accordance with regulations. The treatments that may delivered as an interim preventive CoT between OHA/OHR are defined in the current version of document Interim Care 3800 Codes Prototypes140203, together with those items that are charge exempt.
For existing suppliers there are no changes to the preventive items that may be provided under band 1a, or charging.
2.6.2 Appointment (Care Pathway) data
Data in relation to the transmission specification for prototypes should be transmitted for each patient appointment. It will be a requirement under regulations that prototype contractors submit appointments within 5 days of the appointment date and prototype contracts will be monitored in relation to timeliness of appointment data submission.
Prototype Transmission Specification (26 May 2015) v1.0 12 The majority of care and treatment for which a patient treated under a prototype contract has an appointment, should generate appointment information which would be transmitted to the prototype server service. The information sent with each appointment will vary depending on the type of appointment and care provided.
All appointments - will contain basic appointment information in relation to the patient’s details, attendance or not, duration of the appointment.
OHA/OHR – will also include required transmission information in relation to the oral health assessment
Treatment appointments that are not the end of a CoT – will just contain basic appointment information
Treatment appointments that are the end of a CoT – will contain basic appointment information together with prototype clinical data set information for the CoT (not just that appointment)
Urgent treatment – will contain basic appointment information and when the urgent treatment is completed prototype clinical data set information for the urgent CoT
Treatment on referral – if the patient is being provided with part of their care then a treatment appointment(s) completed with basic appointment information and prototype clinical dataset information when the referral treatment is complete
Private treatment – where private treatment is provided outside an NHS CoT (i.e. not as an alternative to part of an NHS CoT) as one or more appointments, the private treatment appointments should be submitted containing basic appointment information together with clinical data set information for each appointment.
In all cases when a NHS CoT is complete an FP17 should also be submitted in accordance with the relevant GDS and PDS regulation.
Prototype Transmission Specification (26 May 2015) v1.0 13 3 Process Data Sets
The sections below contain an entire list of potential data capture items that will be collected as part of the prototype contract. The following points should be noted:
There are now three appointment types that require submission to the NHSDS; Oral Health Assessment / Review (OHA/R), Treatment and Private.
All appointments require basic appointment information to be transmitted
Where a patient attends a single appointment for treatment an FP17 is raised and submitted as normal for GDS / PDS contracts and a treatment appointment is submitted containing:
o Dental Provider / Performer details o Patient details o Appointment details o Clinical Dataset items If a patient attends multiple appointments for treatment and the appointment is not for the completion of an episode or care (also known as a course of treatment) a treatment appointment is submitted but without a clinical dataset.
If the patient does not attend an appointment that has been booked a treatment appointment is submitted indicating that the patient did not attend.
If a patient is referred to a pilot contract an OHA/R is completed only if the patient is referred for the full pathway.
The only instance where all the Oral Health Needs domains are not completed is if the patient is edentulous, where the only mandatory domain is soft tissue or patients under 3 where caries is the only mandatory domain. In this context domain completion means either a RAG status is present and / or a non-completion reason is given.
For child patients less than 7 the Soft Tissue domain is non mandatory.
Prototype Transmission Specification (26 May 2015) v1.0 14 3.1 Practice/Performer Details
Every appointment needs to be linked to the practice and the relevant performer. XML Data Data Validation Mandatory / Valid Discontinued Business tag Item/description item/Field Optional From Rule Name cno Contract Contract an - unbounded M V1 2.0 perf Performer PNeurmfobremrer an -– unbounded M V1 3.0, 5.0, Number value of ‘000000’ if Performer does not have a NHS 17.0, 69.2 performer number loc Location Location an - unbounded M V1 Unique code to show main location of address authori Authorisation DPB PIN Personal ID assigned to a dentist to M V1 4.0 authorise message transmission
3.2 Patient Details
Patient details should be recorded when the Patient first makes contact with the practice. Details should be checked and if necessary updated at every appointment. The patient details will link to the performer and contract number. Valid Discontinued Business XML tag Data Data Validation Mandatory / From Rule Item/description item/Field Optional Name dpmsptid Unique DPMS DPMS patient Varchar 64 M V1 11.1 patient identifier ID nhsno NHS no an..10 O V1
Prototype Transmission Specification (26 May 2015) v1.0 15 Valid Discontinued Business XML tag Data Data Validation Mandatory / From Rule Item/description item/Field Optional Name ptsur Patient’s details Surname a64 M V1 11.2 ptfn First forename a64 M V1 11.2 ptttl Title a..12 O V1 11.2 Free text adrln an..32 Line 1 V1 11.2 Address Line Repeat 5 times. Mandatory pc Postcode an..8 OLine 2–5 V1 11.2 prevadr ln Pr evious an.. 32 Line 1–5 V1 V3 Addr ess Line Repeat 5 t im es. O p t ional If lived at curr ent address f or less t han t hree year s prevpc Pr evious an.. 8 O V1 V3 Postcode pvsur Previous a 64 O V1 11.2 surname sex Sex a1 M V1 Drop- down list: M F dob DOB date M V1 DDMMYYYY t iprevis T his i t em t o be T im e since n1 O V1 V3 en t ered once previous visit Dr op- down lis t : when t o den t ist 1 – 0 - 6 m on t hs ( V1 and V2) pa t ient is new or 2 – 6 – 12 m on t hs ( V1 and V2) hasn’t at t ended 3 – 1 – 2 year s ( V1 and V2) in t he past 2 4 – More t han 2 year s (V1 and year s. V2) 5 – Fir st Appointm ent ( f rom V2)
Prototype Transmission Specification (26 May 2015) v1.0 16 Valid Discontinued Business XML tag Data Data Validation Mandatory / From Rule Item/description item/Field Optional Name connum l Con t act Details Phone num ber an32 O V1 V3 - landline connum m Phone num ber an32 O V1 V3 - m obile email E-mail address an64 O V1 ethnor E t hnic orig in n2 M V1 V3 Dr op- down lis t : 1 – W hi t e Br i t ish 2 – W hi t e Ir ish 3 – Ot her W hi t e Backg r ound 4 – W hi t e + Black Caribbean 5 – W hi t e and Black Afr ican 6 – W hi t e and Asian 7 – Ot her Mixed Backg r ound 8 – Asian or Asian Br i t ish I ndian 9 – Asian or Asian Br i t ish Pak is t ani 10 – Asian or Asian Br i t ish Bang ladeshi 11 – Ot her Asian Backg round 12 – Black or Black Br i t ish Car ibbean 13 – Black or Black Br i t ish A f r ica n 14 – Ot her Black Backg round uso f eng Use of Eng lish How we l l does n115 – Chinese M V3 V1 t he pa t ient Dr op- down lis t : speak 1 – well Eng lish? 2 – wi t h help 3 – inter pre t er r eq uir ed T he abili t y of t he pa t ient t o Prototype Transmission Specification (26 May 2015) v1.0 17 Valid Discontinued Business XML tag Data Data Validation Mandatory / From Rule Item/description item/Field Optional Name parg uasur Paren t /G uar dian Surname of a64 O V3 V1 Parent or G uar dian parg uaf n Fir st f orenam e a64 O V3 V1 of Parent or G uar dian exrm cd Exemp t ions n2 O V1 V3 and Dr op- down lis t : r emissions 27 – Pa t ient under 18 – No evidence seen 28 - Patient under 18 – evidence seen 13 – Full r em ission – No evidence seen 14 - Full r emission– evid ence seen 15 – Par t ial r em ission – No evidence seen 16 – Par t ial r em ission – evidence seen 3 – Expec t ant m other – No evidence seen 4 – Expec t ant m other – evidence seen 5 – Nursing m o t her – No evidence seen 6 – Nursing m o t her – ev i dence seen 1 – Ag ed 18 in f ull-t im e education – No evidence seen 2 - Ag ed 18 in f ull- t im e education – evidence seen
Prototype Transmission Specification (26 May 2015) v1.0 18 Valid Discontinued Business XML tag Data Data Validation Mandatory / From Rule Item/description item/Field Optional Name 17 – I ncom e Support – No evidence seen 18 – I ncom e Support – evidence seen exrm cd Exemp t ions 31 –T ax Cr edit – No evidence O V1 V3 and seen r emissions 32 – T ax Cr edit – evidence seen 25 –Jobseek er s allowan ce – No evidence seen 26 - Jobseek er s allowan ce – evidence seen 33 – Pension cr edit g uaran t ee cr edit – No evidence seen 34 - Pension cr edit g uaran t ee cr edit – evidence seen 35 – Pr isoner 84 – I ncom e-r ela t ed em ploym ent and suppor t allowance – No evidence seen 83 - I ncom e-r elated employm ent and suppor t allowance – evid ence seen gpnam GP GP Name a64 O V1 V3 gpconnuml GP Phone an32 O V1 V3 Number predennam Previous Previous a64 O V1 V3 Dentist Dentist Name predenadrln Previous an32 Line 1–5 V1 V3 Dentist Repeat 5 times Optional Prototype Transmission Specification (26 May 2015) v1.0 19 Valid Discontinued Business XML tag Data Data Validation Mandatory / From Rule Item/description item/Field Optional Name Address line
Prototype Transmission Specification (26 May 2015) v1.0 20 3.3 Appointment Details Fields that are not applicable / appropriate for appointments where the appointment type is ‘private’ ie. private treatment unrelated to an NHS CoT but would otherwise be mandatory are shown in column ‘private appointment’ as a default value of ‘PRIVATE’.
For all appointments. XML tag Data Data item/Field Validation Mandatory / Private Valid Discontinued Business Item/description Name Optional appoint From Rule ment Clrn Unique identifier Message Varchar(16) M PRIVATE V1 16.0, Reference This will be the unique 16.1, 16.2 Number identifier for each appointment. appttype Type of Type of n3 M M V2 23.7 Appointment Appointment Drop-down list OHA / OHR – 1 Value ‘3’ 23.8 Treatment - 2 should be selected Private - 3 23.9
Only one appointment type should be selected. If OHA/OHR combined with treatment
If OHA/OHR with/ without treatment or private treatment value ‘1’ OHA/OHR should be selected If NHS treatment with / without private treatment value ‘2’ treatment should be selected. Only where all private (outside NHS CoT) should value ‘3’ private
Prototype Transmission Specification (26 May 2015) v1.0 21 XML tag Data Data item/Field Validation Mandatory / Private Valid Discontinued Business Item/description Name Optional appoint From Rule ment be selected apptdat Appointment Date Appointment DDMMYYYY M M V1 17.0 Date Must be a valid date apptime Appointment Time Appointment n4 M M V2 17.0 (based on 24 Time HHMM hour clock) apptdur Appointment Appointment n3 M M V1 17.0 Duration. The Duration MMM time spent on an Time in minutes appointment or the time set aside We want the actual time if for an the appointment is kept and appointment the time set aside if cancelled. privdeclaratio Confirmation that Private Boolean O M PRO 70.0, 70.1, n patient has given Treatment True V1 70.2, 70.3 explicit consent for Declaration False private only treatment to be Wording to be agreed submitted ‘I declare that the patient has provided explicit consent for their details of their private only course of treatment to be submitted to NHS Dental Services…’ Declaration should default to true. If patient does not give consent the data should not be submitted. patr e f cc Patient r e f err ed Patient Boolean O V2 V3 fr om ano t her Ref err ed T r ue
Prototype Transmission Specification (26 May 2015) v1.0 22 XML tag Data Data item/Field Validation Mandatory / Private Valid Discontinued Business Item/description Name Optional appoint From Rule ment dentist f or False con t inuing car e ptatt Did patient attend Did patient Boolean M M V1 18.2, 71.3 attend True False nonatt Non n1 O M V1 V3 attendance Drop-down list: 1 – failed to attend 2 – cancelled by patient 3 - cancelled by practice apptcom Was appointment Appointment Boolean True False O V2 V3 completed completed If ‘false’ must enter reason for non- completion. If ‘false’ only Practice/Performer, Patient, and Appointment details will be validated apptnonco Reason for non- Non- n1 O V2 V3 m completion completion Drop-down list: reason 1 – Loss of compliance from Patient 2 – Dentist decision When an appointment has not been completed, a further appointment to complete the work should be offered to the Patient. At this appointment the OHA, OHR, IC or treatment must be completed. fp17started Start of the Has FP17 Boolean M Private V1 23.4 started True
Prototype Transmission Specification (26 May 2015) v1.0 23 XML tag Data Data item/Field Validation Mandatory / Private Valid Discontinued Business Item/description Name Optional appoint From Rule ment capitation interval False signified by the This is to be derived from start of an the system and is the appointment. The date of acceptance of the ‘true’ statement FP17. I.e. the date of must only be used acceptance of a claim for once on the dental activity. appointment Set as ‘true’ if the against which an appointment FP17 starts. coincides with the claim (includes urgent ) at the start of a treatment Set ‘false’ if it does not. fp17startdat The ‘true’ The date of DDMMYYYY O Private V2 23.1 e statement must the start of the only be used FP17 Must be a valid date With once, on the This is to be derived from dependenc appointment the system and is the y on against which an date of acceptance of the fp17started FP17 starts. FP17. I.e. the date of acceptance of a claim for dental activity. If fp17started marked as ‘true’ a valid date must be provided fp17complet Completion or Has the FP17 Boolean M Private V3 23.52, 62.0 eddiscontinu Discontinuation of been True ed the FP17 completed or discontinued False
If True the User must transmit the
Treatment section
Prototype Transmission Specification (26 May 2015) v1.0 24 XML tag Data Data item/Field Validation Mandatory / Private Valid Discontinued Business Item/description Name Optional appoint From Rule ment fp17enddate Closure of the FP17 The date DDMMYYYY O Private V2 23.3 the FP17 With was Must be a valid date dependency 23.10 closed. on fp17completd This can If discontinued be the date fp17completeddiscontinued of marked as ‘true’ a valid date completion must be provided or the date of the last appointme nt banding Band of CoT Band of 1 – Band 1 O Private V1 23.46 CoT as 2 – Band 2 With entered on 3 – Band 3 dependency 23.10 the FP17 4 – Urgent on 5 – IC advice only fp17complete ddiscontiued cpclosedate DDMMYYYY O Private V2 V1 PRO 30.0 The Care The point of closure Pathway of the care pathway closure date clrnlink The OHA/OHR the Assessment If the appointment is part of O Private V2 V1 PRO 26.0 appointment stems Link Date a pathway submit the date from. of the last OHA/R DDMMYYYY
Must be a valid date cpclosecompl Has the Care Has the Care Boolean O Private V2 V1 PRO 30.0 ete Pathway (all Pathway been True completed? False Prototype Transmission Specification (26 May 2015) v1.0 25 XML tag Data Data item/Field Validation Mandatory / Private Valid Discontinued Business Item/description Name Optional appoint From Rule ment planned care) been If ‘false’ you must give the completed? reason for the pathway not being completed. cpnoncomrea The reason for the The Care n1 O Private V2 V1 PRO 30.1 son care pathway not Pathway 1 – Patient failed to return being completed non- 2 – Patient Request completion 3 – Dentist decision reason
Prototype Transmission Specification (26 May 2015) v1.0 26 3.4 Oral Health Assessment
Separate requirements for Edentate Patients and for Children under 3, where these differ to the normal Care Pathway, are described in the Validation column. Assessment must be linked to patient, performer and contract number.
XML Tag Data Item / Data Item / Validation OHA/OHR Valid Discontinued Business Description Field Name Mandatory From Rule / Optional ohatyp OHA/OHR Type of Oral n1 M V1 14.2, 19.0, must be Assessment Drop-down list: 32.0, sent only 1 – OHA 33.0, 33.1, when 2 – OHR 33.2, 54.0, complete. 55.0, Where this is the first 55.1, 55.2, assessment appointment 55.3 since the start of the Pilot the Patient should have an OHA. All subsequent assessments will be an OHR New Patients to the Practice should have an OHA. modifyingfacto Modifying Are any Boolean M V3 31.0 rs Factors modifying True factors False present If true must select at least one option from ‘selectfactors’
‘True’ must be selected if any of the following:
Medical History: Prototype Transmission Specification (26 May 2015) v1.0 27 XML Tag Data Item / Data Item / Validation OHA/OHR Valid Discontinued Business Description Field Name Mandatory From Rule / Optional ‘yes’ response to any specified question in the Medical History
Social History ‘no’ response to question 1, any response to question 3, ‘yes’ response to questions 4,5,7,8,9
Other: ‘yes’ response to Social History question 2 or 6 or; A high risk site (a soft tissue lesion in floor of mouth or lateral border tongue). selectfactors Select n1 O V3 31.1 Modifying multi-select factors Drop-down list social history – 1 medical history – 2 Other - 4
It is possible to select one or more of these modifying factors, so expected values are 1, 2, 3, 4, 5, 6, 7 declaration A Declaration Has the pre- Boolean True False M V2 56 . 0, 56 . 1, that the populated data 56 . 2, 56 . 3. Clinician has been reviewed The declaration must be 55.0, 55.1, reviewed the and where worded as follows: 55.2, 55.3 pre- necessary I declare that I have carried populated updated and is out a review of this patient's data, made the Performer oral health and that the any updates now information contained within Prototype Transmission Specification (26 May 2015) v1.0 28 XML Tag Data Item / Data Item / Validation OHA/OHR Valid Discontinued Business Description Field Name Mandatory From Rule / Optional required and confirming this the oral confirms that as correct? health review has been the data is updated accordingly and is a correct. correct and complete record. urg casaca Ur g ent Car e Ar e Boolean N / A V1 V3 Assessment - Car ies T r ue Car ies present False urg casapc Ur g ent Car e I s Plaq ue Boolean N / A V1 V3 Assess Contr ol T r ue ment - satis f act False Plaq ue ory pa t att Pat t ern of Freq uency of n1 M V1 V3 pa t ient at t ndance Dr op- down lis t : at t endance 1 – At t ends r eg ularly ( v1 and v2) 2 – At t ends f or urg ent car e only ( v1 and v2) 3 – At t ends Irr eg ularly ( f rom v2) 4 – Fir st Appointm ent ( f rom v2) T his q ues t ion is t o help discover t he past his t ory of at t endance. I t should be ask ed at t he O HA and of pa t ien t s at t ending f or urgent care. edentate Edentate Is the patient Boolean M V2 34.1, 42.63 Patient edentate? True False patc ho i Pa t ient Cho ic e T ype of c are n1 M V1 V3 c hos en b y Dr op- do wn l is t: pat i ent 1 – Ur g ent c are onl y ( v1 an d v2) 2 – O H A an d f ull Care Pa th wa y ( f r om v2)
Prototype Transmission Specification (26 May 2015) v1.0 29 XML Tag Data Item / Data Item / Validation OHA/OHR Valid Discontinued Business Description Field Name Mandatory From Rule / Optional 3 – O H A an d T r eatm ent on l y ( f r om v2) 4 – Ur g ent C are a nd O H A orthoassess Has an Has an Boolean O V2 35.0 Orthodontic Orthodontic True Dependent assessment assessment False on age of been been carried Required for patients aged 12- patient carried out? out? 18 years of age medhist Medical history Medical Boolean M V1 38.03, History True 38.41, recorded / False 38.52, reviewed / 38.6, 38.7 amended ex t exam Recor d Finding s of Boolean M V1 V3 ex t ernal ex t ernal T r ue examination examination False r ecor ded uppercanines Upper Canines Are upper Boolean O V3 35.0 canines True Dependent present? False on If false Must answer whether orthoasses an assessment of unerrupted s canines has been completed If orthoassess ‘false’ required field asunca Assessment of Assessment of Boolean O V1 35.0 Unerrupted Unerrupted True Dependent Canines Canines False on Completed uppercanin es. If ‘false’ required field
Prototype Transmission Specification (26 May 2015) v1.0 30 3.4.1 Current Problems
XML tag Data Item Data item/Field Validation OHA/OHR Valid Discontinued Business Description Name Mandat From Rule ory/ Option al curprodes Current Problems Current n1 M V1 problems Multi-select: Previously description 1 – None discontinu 2 – Pain ed but re- 3 4 –Problems Eating introduced for PRO Expected values, 1,2,3,54, 6 V1
curprodes_ot her Other Free-text Reason Varchar 64 O V1 V3
Prototype Transmission Specification (26 May 2015) v1.0 31 3.4.2 Tooth Assessments
Tooth assessment data to be derived from clinical charting. XML Tag Data Item / Data Item / Validation OHA/OHR Valid Discontinued Business Description Field Name Mandatory From Rule / Optional upperteeth Number of n..2 M V3 32.0, 32.1, standing 0-16 36.0, 36.1, teeth in upper 36.2, 36.3 arch Derived from base-line charting, excluding teeth charted as missing, unerupted, bridge pontic or artificial tooth.
If the deciduous and permanent successor are both present only the permanent successor should be counted. Supernumerary teeth should not be counted. Minimum = 0 Maximum = 16
lowerteeth Number of n..2 M V3 32.0, 32.1, standing teeth 0-16 36.0, 36.1, in Derived from base-line charting, 36.2, 36.3 lower arch excluding teeth charted as missing, unerupted, bridge pontic or artificial tooth
If the deciduous and permanent successor are both present only
Prototype Transmission Specification (26 May 2015) v1.0 32 XML Tag Data Item / Data Item / Validation OHA/OHR Valid Discontinued Business Description Field Name Mandatory From Rule / Optional the permanent successor should be counted.
Supernumerary teeth should not be counted.
Minimum = 0 Maximum = 16
defrest Defective Number of M V3 32.0, 32.1, n2 Restorations teeth 36.0, 36.1, with non- Cumulative count of teeth where 36.2, 36.3, carious restorations charted as requiring 36.9 defective replacement / part replacement restorations but no caries charted in relation requiring to the restoration replacement
decayteethper Decayed teeth Number of n2 O V3 36.5, m - permanent decayed 37.176, permanent Cumulative count of tooth 37.187, teeth notations where established 32.0, 32.1, carried charted. 33.1, 36.0, 36.1, 36.2, Minimum = 0 36.3, 36.8, 36.9 Maximum = 32 ‘Decayed’ means teeth with established caries Should be transmitted for all patients aged 6 years and older.
Prototype Transmission Specification (26 May 2015) v1.0 33 XML Tag Data Item / Data Item / Validation OHA/OHR Valid Discontinued Business Description Field Name Mandatory From Rule / Optional
missteethper Missing teeth - Number of n2 O V3 36.7, m permanent missing 37.12, permanent Cumulative count of permanent 37.213, teeth teeth charting as missing 32.0, 32.1, including thouse replaced bty 36.0, 36.1, bridge ponitcs and dentures 36.2, 36.3 excluding teesth charted as unerupted.
Minimum = 0 Maximum = 32
Any tooth should only be counted once.
Should be transmitted for all patients aged 12 years and older. ‘missing’ means where a tooth has been extracted.
filledteethper Filled teeth - Number of n2 O V3 36.7, m permanent permanent Cumulative count of 37.314, filled teeth permanent teeth charted as 37.154, restored with direction 37.165, 32.0, 32.1, restorations (fillings) or with 36.0, 36.1, indirect restorations of the 36.2, 36.3 following types: crowns, inlays, bridge retainers
Minimum = 0 Maximum = 32 Prototype Transmission Specification (26 May 2015) v1.0 34 XML Tag Data Item / Data Item / Validation OHA/OHR Valid Discontinued Business Description Field Name Mandatory From Rule / Optional
Any tooth should only be counted once.
Should be transmitted for all patients aged 12 years and older.
Where a restored tooth is decayed this should be counted as decayed.
decayteethdec Decayed teeth Number of n2 O V3 32.0, 32.1, – decayed 33.1, 36.0, deciduous deciduous Cumulative count of deciduous 36.1, 36.2, teeth tooth notations where 36.3, 36.4, established caries charted 36.8, 36.9, 37.176, 37.187, Minimum = 0 Maximum = 20
Should be recorded and transmitted for all patients aged 0 up to and including 11 years of age.
‘Decayed’ means teeth with established caries
‘caripres’ ‘4 – established’ only missteethdec Missing teeth - Number of n2 O V3 36.6, deciduous t missing 37.12,
Prototype Transmission Specification (26 May 2015) v1.0 35 XML Tag Data Item / Data Item / Validation OHA/OHR Valid Discontinued Business Description Field Name Mandatory From Rule / Optional deciduous Cumulative count of missing 37.213, teeth deciduous teeth 32.0, 32.1, ULA, ULB, URA, URB, LLA, 36.0, 36.1, LLB, LRA, LRB should be 36.2, 36.3 excluded from the count
Minimum = 0 Maximum = 12
Should be transmitted for all patients aged 0 up to and including 6 years of age.
‘missing’ means where a tooth has been extracted
filledteethdec Filled teeth - Number of n2 O V3 36.6, deciduous deciduous Cumulative count of deciduous 37.314, filled teeth tooth notation where any 37.154, restoration (filling) present 32.0, 32.1, 36.0, 36.1, 36.2, 36.3, 37.16 Minimum = 0 Maximum = 20
Should be transmitted for all patients aged 0 up to and including 6 years of age.
Where a restored tooth is decayed this should be counted as decayed. Prototype Transmission Specification (26 May 2015) v1.0 36 XML Tag Data Item / Data Item / Validation OHA/OHR Valid Discontinued Business Description Field Name Mandatory From Rule / Optional
t oothid Den t al chart T oo t h I D – All an3 O V1 V3 r ecor d T ee t h Dr op- down lis t : UR8 T his is a Perm anent UR7 compound UR6 list. UR5 UR4 UR3 UR2 UR1 URS UL1 UL2 UL3 UL4 UL5 UL6 UL7 UL8 ULS LR8 LR7 LR6 LR5 LR4 LR3 LR2 LR1 LRS LL1 LL2 LL3 LL4 Prototype Transmission Specification (26 May 2015) v1.0 37 XML Tag Data Item / Data Item / Validation OHA/OHR Valid Discontinued Business Description Field Name Mandatory From Rule / Optional LL5 LL6 LL7 LL8 LLS
t oothid Deciduous URE URD URC URB URA URS ULA ULB ULC ULD ULE ULS LRE LRD LRC LRB LRA LRS LLA LLB LLC LLD LLE LLS
URS, ULS, LRS, LLS are t o indicate addi t ional t eeth. Use t hese f or deciduous and adult Prototype Transmission Specification (26 May 2015) v1.0 38 XML Tag Data Item / Data Item / Validation OHA/OHR Valid Discontinued Business Description Field Name Mandatory From Rule / Optional t ee t h. unerup Uner up t ed Boolean M V1 V3 T r ue False I ndicate f or each t oo t h using t oo t h id codes t oor es Restor a t ion t o Boolean M V1 V3 t oo t h T r ue False I ndicate f or each t oo t h using t oo t h id codes. T his r elates t o any r estor a t ion and is intended as a q uick coun t . s t at t oo S t ate of t oo t h n2 O V1 V3 Mul t i-s e l ec t ( Va l ues 1 – 20 are V1 and V2. Va l ue 21 is f r om V2) Dr op- do wn l is t of s tate of teeth: 1. S oun d T ooth 2. M iss ing T ooth 3. Ar t i f ic ial T ooth 4. G o l d Cro wn 5. Ceram ic s 6. P orc ela in Cr o wn 7. Porc e l ain Re t ain er – Br id ge 8. G o l d Re ta i ner – Cr o wn 9. G o l d P on t ic – Br id ge 10. Porc e l ain P on t ic – Br id ge 11. Part i all y erup ted 12.Ro ot Fil lin g 13.Un erup t ed T ooth 14. Ven eer 15. Pin 16.M es ia l M ov em ent – ( Ha l f )
Prototype Transmission Specification (26 May 2015) v1.0 39 XML Tag Data Item / Data Item / Validation OHA/OHR Valid Discontinued Business Description Field Name Mandatory From Rule / Optional 17.M es ia l M ov em ent – ( Fu l l) 18.D is tal Mo vem ent – ( Ha l f ) 19.D is tal Mo vem ent – ( Fu ll) 20.O th er 21.Fr ac tured T ooth ‘2. Miss in g’ m eans m iss ing due to ex trac t i on. surf ace Sate of t oo t h T oo t h sur f ace unbo und ed O V1 V3 sur f ace Dis tal Mes ia l Pa l ata l Lab ial Lin gua l Incis al Bucc al Occ lus al S t at t oosurf S t ate of t oo t h O V1 V3 surf ace Sta t e of too t h sur f ac e dr op - do wn lis t: ( Va l ues 1- 6 are V1 a nd V2. Va l ues 7- 9 are f r om V2) 1. No f i l l ing 2.Fi l l i ng – Dec a ye d 3.Fi l l i ng – Am algam 4.Fi l l i ng – Com pos ite 5.Fi l l i ng – Io nom er 6.Fi l l i ng - G o ld 7.No car i es- de f ec tiv e tooth /res torat ion-r ep lac em ent of r es toratio n req uir e d’ 8.No c ar i es- de f ec tiv e tooth /res torat ion-r ep lac em ent of par t of res torat i on re qu ir ed ’
Prototype Transmission Specification (26 May 2015) v1.0 40 XML Tag Data Item / Data Item / Validation OHA/OHR Valid Discontinued Business Description Field Name Mandatory From Rule / Optional 9.No c ar i es- de f ec tiv e tooth /res torat ion-r ep lac em ent of r es toratio n n ot r eq uir e d’ Drop- dow n list s of too th surface s. T her e ar e 5 s urf ac es f or eac h too t h. For eac h t ooth s ur f ac e, l i nk to one or m ore of the item s from the s tate of tee t h dr o p- do wn l is t. T r ansmit t he s t a t e of each surf ace on every t oo t h i n t he m ou t h even if t her e has been no t hing char t ed on t hat too t h. Caripres Caries present n1 O V1 V3 (Must still 44.032.0, Drop-down list: be recorded 32.1, 36.0, 1 - None but not 36.1, 36.2, 2 – Early transmitted. Is 36.3 required by 3 – Arrested the system to 4 – Established calculate the Indicate worst case for each Caries RAG) tooth surface using tooth surface id codes – toosurf
Prototype Transmission Specification (26 May 2015) v1.0 41 3.4.3 Mouth Level Data
XML Tag Data Item / Data Item / Validation OHA/OHR Valid Discontinued Business Description Field Name Mandatory From Rule / Optional toos urlos T ooth Surf ac e n1 O V1 PRO V1 33.0 Los s Dr op- do wn l is t: Dependent 1 - Exc ess iv e (Red) on age 2 - Mo der ate (Am ber ) patient and 3 - Norm al (Gr een) edentate
T his is a s um m ing up f or the who l e m outh.
It is req uir e d to ca lc u l ate th e T ooth Surf ac e Los s R AG
Unless patient edentate or less than 7 years age this field is mandatory. sinsep T he Den t al Sinus Boolean M V1 V3 presence of Sepsis T r ue Den t al Sinus False Sepsis in t he T his is m ou t h level r ather t han m ou t h t oo t h level da t a r eslev Restor a t ion Restor a t ion n1 M V1 V2 Level in Level Dr op- down lis t : Mou t h 1 – Hig h 2 – Medium 3 – Low T his is m ou t h- level r ather than ind i vidual t oo t h data. G uida nc e to be de ve lop ed t o def ine hig h, m edium and l o w dur in g tr a in i ng wit h cl i nici ans . plaqcon Plaque Control n1 O V1 33.2, 45.0 Drop-down list: 1 – Satisfactory Dependent 2 – Unsatisfactory Prototype Transmission Specification (26 May 2015) v1.0 42 XML Tag Data Item / Data Item / Validation OHA/OHR Valid Discontinued Business Description Field Name Mandatory From Rule / Optional This is mouth level rather than on age of tooth level data. patient and edentate. Unless edentate ‘true’ or patient less than 3 years age this field is mandatory softisass Soft Tissue n1 O V1 V3 (Must still 33.0, 34.1 Assessment Drop-down list Dependent be recorded 1 – Lesions requiring on age but not referral transmitted. 2 – Lesions Is required 3 – No lesions by the This is mouth level rather than system to tooth level data calculate the Unless patient less than 3 Soft Tissue years age this field is RAG) mandatory
3.4.4 Sextant Section
XML Tag Data Item / Data Item / Validation OHA/OHR Valid Discontinued Business Description Field Name Mandatory From Rule / Optional sextantid Plaque level, BPE Score a2 O V1 39.20, 40 . 0 bleeding and Drop-down list: bone loss. The sextants correspond to teet as Dependent follows: 8-4 (upper right); 3-3 (upper on age front); 4-8 (upper left); 4-8 (lower left); (patient less 3-3 lower front; 4-8 (lower right) than 18 UR years) or UF edentate. UL LL
Prototype Transmission Specification (26 May 2015) v1.0 43 XML Tag Data Item / Data Item / Validation OHA/OHR Valid Discontinued Business Description Field Name Mandatory From Rule / Optional LF LR
n1 Dr op- do wn l is t: V1 V2 bpesc ore O 0 - peri odo nt i um health y 1 - b l eed in g af ter prob in g 2 - c alc u l us pres en t ar o und def ec t i ve m argins of f illi ngs or cr o wns 3 - 3 - 5. 9m m pock eting 4 - = >6m m depth of poc k et i ng 5 - '*' A ttac hm ent los s (prob ing dept h p lus rec ess ion) of 7m m or m ore at an y si te For eac h sex ta nt s e l ec t a s c ore f r om the dr op do wn lis t. T h i s s hou l d be the h i gh es t sc ore f or eac h sex tan t. M V1 V2 bpesc ore bpesc ore bpesc ore bpescore Bpe score n1 Drop-down list: O V2 39.20 Bpe score 0 - No pockets >3.5 Dependent For each mm, no calculus/ age(<18 sextant select a overhangs, no years) or score from the bleeding after probing edentate drop down list. (black band This should be completely visible) the highest score for each 1 – No pockets sextant. >3.5mm, no calculus/ The sextants Overhangs; but correspond to bleeding after probing teeth as (black band follows: completely visible) 8-4 (upper right); 3-3 2 - No pockets (upper front); 4- >3.5mm, but supra- 8(upper left); 4- Prototype Transmission Specification (26 May 2015) v1.0 44 XML Tag Data Item / Data Item / Validation OHA/OHR Valid Discontinued Business Description Field Name Mandatory From Rule / Optional 8 (lower left); 3- or subgingival 3(lower calculus/overhangs front); 8-4 (black band (lower completely visible) right). 3 – Probing depth 3.5-5.5mm (black band partially visible, indicating pocket of 4-5mm)
4 – Probing depth >5.5mm (black band entirely within the pocket, indicating pocket of 6mm or more) bleeding
5 – 1* No pockets >3.5mm, no calculus/Overhangs; but bleeding after probing and Furcation
6 – 2* No pockets >3.5mm, but supra- or subgingival calculus/overhangs and Furcation
7 – 3* Probing depth 3.5- 5.5mm and Furcation
8 – 4* Probing depth >5.5mm and Furcation Mandatory for patients aged 18 and over but optional for patients under 18. Prototype Transmission Specification (26 May 2015) v1.0 45 XML Tag Data Item / Data Item / Validation OHA/OHR Valid Discontinued Business Description Field Name Mandatory From Rule / Optional
9 – no teeth present in the sextant
A valid entry is expected for each sextant ID unless the patient is less than 18 years and / or edentate
ble e Ble ed ing Boolean M V1 V3 T r ue False Se l ec t f or eac h sex ta nt. bleedsext Number of n1 O V3 40.0 bleeding 0-6 sextants on Dependent probing. on age (<18 year) or This is edentate ‘mandatory’ for patients aged 18 years or older an d ‘opt io na l ’ orEde ntat e pa t i ents .
3.4.5 Risk Screening
XML Tag Data Item / Data Item / Validation OHA/OHR Valid Discontinued Business Description Field Name Mandatory From Rule / Optional ragst Soft Tissue – n1 O V1 41.0, 42.0, Clinical RAG Drop-down list: Dependent 42.4, 42.5, Status 1. Red on 42.6, 43.0, 2. Amber stassnonc 43 .1 Prototype Transmission Specification (26 May 2015) v1.0 46 XML Tag Data Item / Data Item / Validation OHA/OHR Valid Discontinued Business Description Field Name Mandatory From Rule / Optional 3. Green omp
stassnoncomp Patient non Boolean O V3 compliant True False
Non-compliant to be used for any patient where not possible to assess soft tissues due to lack of patient compliance. May still be possible for practitioner to provide a RAG for soft tissues ragcar Caries Clinical n1 O V1 34.0, 42.0, RAG status Drop-down list: 42.15, Dependent 42.4, 43.0, 1 - Red on age and 43.1 2 - Amber / or 3 – Green edentate Mandatory field unless patient and less than 3 years and / or carassnon comp edentate or carassnoncomp completed. carassnoncom The reason for n1 O V3 42.2, 42.63 p non 1. N/A completion of 2. Patient non compliant caries assessment This item is Mandatory if no caries assessment has taken place.
Non-compliant to be used for any patient where it is not possible to chart dentition due to lack of patient compliance.
Prototype Transmission Specification (26 May 2015) v1.0 47 XML Tag Data Item / Data Item / Validation OHA/OHR Valid Discontinued Business Description Field Name Mandatory From Rule / Optional May still be possible for practitioner to provide a RAG for caries. r agc arovr i Rec ord a ne w RAG Car ies n1 M RAG overri de Dr op- do wn l is t: V1 V3 s tatus an d 1 - Red se l ec t a 2 - Am ber r eas on f or 3 – Gr ee n c hang in g 4 – n ot a pp lic ab le r agc arovr ir ea v RAG n1 O al Car ies Dr op- do wn l is t: V2 V3 overri de 1 – Ac t i ve C aries re as on 2 – N o Car ies 3 – Pr ev io us His tor y of Car i es 4 – Or tho don tic Pa t ient 5 – Or al Hea l t h Goo d 6 – Or al Hea l t h P oor 7 – O th er If ‘other’ m us t s tate the rea s on as f r ee- text r agc arovr ir ea O ther reas on Fr ee- text O f or varc har 6 4 V1 V3 RAG Car ies O verr id e ragts Tooth Surface n1 O Loss Drop-down list: V1 34.2, 42.0, Clinical RAG 1 - Red Dependent 42.51, status 2 - Amber on age and 42.4, 43.0, 3 – Green / or 43.1 Mandatory field unless patient edentate and aged less than 7 years and / or tsassnonco edentate or tsassnoncomp mp completed.
Prototype Transmission Specification (26 May 2015) v1.0 48 XML Tag Data Item / Data Item / Validation OHA/OHR Valid Discontinued Business Description Field Name Mandatory From Rule / Optional
n1 O tsassnoncomp The reason V3 42.2, 42.63 1. N/A for non 2. Patient non compliant completion of tooth surface loss This item is Mandatory if no assessment tooth surface loss assessment has taken place at the OHA or OHR.
Non-compliant to be used for any patient where not possible to assess tooth surface loss due to patient non-compliance. May still be possible for practitioner to provide a RAG for tooth surface loss. rag tso vri Reco rd a RAG Too th n1 M ne w RAG Su rfac e Drop -do wn V1 V3 s ta tus an d o ve rrid e li st: sel ec t a 1 - Red reas on fo r 2 - c hang in g Am be r 3 – Gree n 4 – n ot a ppl ica b l e Th e RAG Too th Su rfac e Ove rrid e is Ma nda tory fo r Pa tien ts a ge d 7 an d ove r. Yo u mus t reco rd an d t rans m i t a T SL RAG Ove rride , s elec t i ng ‘no t app lic able ’ i f ne ce ssa ry , Prototype Transmission Specification (26 May 2015) v1.0 49 XML Tag Data Item / Data Item / Validation OHA/OHR Valid Discontinued Business Description Field Name Mandatory From Rule / Optional fo r Patien ts i n t h i s ag e ban d. rag tso vri It i s Optio na l fo r ch ild re n V3 ag ed 0 t o unde r 7 . Th i s me an s yo u o n l y nee d to re co rd an d t rans m i t da ta fo r thi s age -b an d i f i t i s c lin ica l l y ne cessa ry . rag tso vr i rea va RAG too th n1 O V2 V3 l su rfac e Drop -do wn li st: o ve rrid e 1 – No Too th Su rfac e Lo ss rea so n 2 – Mini m al Too th Su rfa ce L oss 3 – Norma l Too th Su rfac e Lo ss 4 – Othe r If ‘o the r’ m us t sta te th e re aso n a s free -te xt rag tso vr i re a Othe r re aso n Free -te xt O V1 V3 fo r RAG va rcha r Too th 64 Su rfac e Ove rrid e ragper Periodontal n1 O V1 42.0, Clinical Drop-down list: 42.51, RAG status 1 - Red Dependent 42.4, 43.0, 2 - Amber on age and 43.1 3 – Green / or edentate, Mandatory field unless patient or less than 3 years, and / or perassnon edentate or perassnoncomp comp completed
perassnonco The reason for n1 O V3 42.2, 42.63 mp non 1. N/A completion 2. Patient non compliant of
Prototype Transmission Specification (26 May 2015) v1.0 50 XML Tag Data Item / Data Item / Validation OHA/OHR Valid Discontinued Business Description Field Name Mandatory From Rule / Optional periodontal This item is Mandatory if no assessment periodontal assessment has taken place at the OHA or OHR.
Non-compliant to be used for any adult patient where periodontal charting (BPE and bleeding) cannot be completed due to patient non- compliance. May still be possible for practitioner to provide a RAG for perio. r ag per ovr i Recor d a new RAG n1 M V1 V3 RAG Periodontal Dr op- down lis t : s t atus and overr ide 1 - Red select a 2 - Am ber r eason f or 3 – Gr een chang ing 4 – not applicable r agper o vr ir e av RAG n1 O V2 V3 al P erio don tal Dr op- do wn L is t: overri de 1 – Or al Hea l t h Goo d re as on 2 – Or al Hea l t h P oor 3 – N o b lee din g a nd poc k eting 4 – O th er If ‘other’ m us t s tate the rea s on as f r ee- text r ag per ovr ir ea Ot her r eason Free- t ext O V1 V3 f or varc har 6 4 RAG Perio O verr ide recint Recall Interval Recall interval n2 M V1 49.0, 49.1, Validation between 0 and 24 50.0
Prototype Transmission Specification (26 May 2015) v1.0 51 XML Tag Data Item / Data Item / Validation OHA/OHR Valid Discontinued Business Description Field Name Mandatory From Rule / Optional months Relates to patient details. Recall interval following Oral Health Assessment. A suggested interval is calculated by the system using the risk screening rules However the recall interval is determined by the Dentist and is a clinical decision. Rec in t ovr i I s a Recall Boolean M V1 V3 I nter val T r ue O verr ide False Req uir ed? T he inten t ion is t o enable clinicians t o set r ecall intervals based on t heir j udg em ent and show when t hey want t o set a diff erent inter val t han t hat r ecomm ended in t he r isk scr eening r ules. If ‘True’ you m ust en t er the new va lue and s t a t e t he r eason. r ec into vri int Recor d a new Recall I nter val n2 O V2 V3 Recall O verr ide va l ida t ion be t ween 0 and 24 I nter val and m on t hs select a r eason f or chang ing r ec int Recall I nter val n1 O V2 V3 ovr ir e av al O verr ide Dr op- down lis t : Reason 1 – Patient Req uest – t oo
Prototype Transmission Specification (26 May 2015) v1.0 52 XML Tag Data Item / Data Item / Validation OHA/OHR Valid Discontinued Business Description Field Name Mandatory From Rule / Optional soon 2 – Patient Req uest – t oo long 3 – Den t ist Decision – t oo soon 4 – Den t ist Decision – t oo long 5 – T o coor dina t e wi t h I C 6 - Ot her If ‘other’ p l eas e s t ate as f r ee - text r ec int Ot her r eason Free- t ext O V1 V3 ovr ir f or Recall varc har 6 4 e a I nter val O verr ide icmr eq I s an I C I C Req uir ed Boolean M V1 PRO V1 r eq uir ed? T r ue False If ‘ f alse’ a r eason m ust be g iven ( icmr eq r eason) . If ‘tr ue’ an inter val m ust be en t ered ( icint) . icmr eq r eason Reason Reason I C is n1 O V2 V3 46 . 0, 46 . 1, I C is not not r eq uir ed 1 – p at i ent ( Al t houg h not 46 . 2, 46 . 3, r eq uir ed un w i l l in g/ r eq uir ed t o 46 . 4, 47 . 0, u nab le be 48 . 0 2 – n ot a ppr o pr ia t e tr ansm it t ed 3 – d en t is t’s d ec is io n t he I C inter val m ust s t ill be calculated by t he sys t em using t he r isk scr eening Prototype Transmission Specification (26 May 2015) v1.0 53 XML Tag Data Item / Data Item / Validation OHA/OHR Valid Discontinued Business Description Field Name Mandatory From Rule / Optional r ules wi t h t he Den t ist r evie wing and amending t he inter val wher e necessary) ic m intovr i I C I n t erval Boolean O V1 V3 O verr ide T r ue Req uir ed False T he inten t ion is t o enable clinicians t o set I C inter vals based on t heir j udg em ent and show when t hey want t o set a diff erent inter val t han t hat r ecomm ended in t he r isk scr eening r ules. If ‘T r ue’ you m ust en t er t he new valu e and s t ate t he r eason. ic m intovr i i nt I C I n t erval n2 O V2 V3 O verr ide va l ida t ion be t ween 0 and 24 m on t hs ic m intovr ir ea v I C I n t erval n1 O V2 V3 a l O verr ide Dr op- do wn l is t: Reason 1 – Pa t ient Re ques t – to o soon 2 – Pa t ient Re ques t – to o l ong 3 – D en t is t Decisi on – to o soon 4 – D en t is t Decisio n – to o l ong 5 – T o coor d i na t e w i th R ec all Interv al 6 – O th er If ‘other’ p l eas e s t ate as f r ee - text ic m intovr ir ea Ot her r eason Free- t ext O V1 V3 f or varc har 6 4
Prototype Transmission Specification (26 May 2015) v1.0 54 XML Tag Data Item / Data Item / Validation OHA/OHR Valid Discontinued Business Description Field Name Mandatory From Rule / Optional I C I n t erval O verr ide caplgiv Patient has a Care plan Boolea M V1 51.0, 51.1, record given n 51.2, 52.0 of care Plan to patient. Tru e Fals e The Care Plan is given to the patient at the OHA. It may be updated at the OHR. trplgiv Treatment Plan Treatment Boolea M V1 52.0 Plan given to n True Patient. False Linked to Treatment
adcareq Need for Is Advanced Boolean M V1 53.0 Advanced Care True Care Required? False This question is to ensure clinicians specifically consider and indicate whether advanced care is required. referral Referral. Is a referral Boolean M V2 64.0 required? True False privprop Private Has private Boolean M V3 24.0 treatment treatment True proposed been False planned as part The private treatment is only of the pathway as an alternative to NHS, i.e. where there is a clinical need.
Prototype Transmission Specification (26 May 2015) v1.0 55 XML Tag Data Item / Data Item / Validation OHA/OHR Valid Discontinued Business Description Field Name Mandatory From Rule / Optional This question must be answered at the completion of an OHA/OHR.
Prototype Transmission Specification (26 May 2015) v1.0 56 3.4.6 Treatment Plan
XML Tag Data Item / Data Item / Validation OHA/OHR Valid Discontinued Business Description Field Name Mandatory From Rule / Optional caretr ear eq Is Care an d I s Car e and n1 M V2 V3 tr e atm ent Drop-do wn list T r eatm ent 1 – Treatment required – pat ient acc ep t ed r equir e d? Req uir ed? 2 – Treatment not required 3 – Treatment required – pat ient dec lined
For all pa t ients excluding Ref erral and Dom ic iliary: I f t reatm ent is required and t he pat ient has acc ept ed t he t reatm ent planned and later t he t reatm ent provided m us t be en t ered.
For Ref erral and Dom ic iliary pa t ien t s onl y: I f t reatm ent is required and t he pa t ient has acc ep t ed t he t reatment required mus t be ent ered. tr eapla T r eatm ent/Inter i T r eatm ent/I n t e Item s of s ervic e code - SD R O V1 V3 m Care rim Dr op- do wn l is t: pla nne d – Care Planned t oot h an d – Per to oth and per t oot h surf ac e tooth t oo t h and ‘too th i d’ and ‘s urf ac e’ s urf ac e Item s t oo t h of surf ace Serv ic e c ode ( SDR) attac he d as App end ix . T he T r eatm ent Pla n is g i ven to t he pat i ent at the O H A.
Prototype Transmission Specification (26 May 2015) v1.0 57 XML Tag Data Item / Data Item / Validation OHA/OHR Valid Discontinued Business Description Field Name Mandatory From Rule / Optional It m ay be upda ted at the O HR. adc ac at Deter m ine t yp e T ype of n1 O V1 V3 of Ad vanc e d Dr op- do wn l is t: Ad vanc Care ( va l ues 1- 5 are v1 and v2 e d Car e Va l ues 6- 7 are f r om v2) need ed 1 – Ad vanc e d P erio don tal T her ap y 2 – R oot C ana l T her ap y 3 – I ndir ec t Res torat io ns 4 – M eta l Bas ed Part ia l De ntur es 5 - O ther 6 – Pae dod ont ic s 7 – M in or Or al Surg er y
If ‘5 – ot her ’ is s e l ec ted the other t yp e of ad vanc e d care nee ded m us t be rec orde d. adcaca t _o t her Ot her Reason Free- t ext O V1 V3 varchar 64 Recor d t he o t her t ype of advanced care r eq uir ed adcalev Level of n1 O V1 V3 Advanced Level of Car e Dr op- down lis t : Care needed 1 – Level 1: Pr ocedur e / condi t ions t o be perf orm ed or m anag ed by a dentist comm ensur ate wit h leve l of com pe t ence as de f ined by t he Curr iculum f or Dental Founda t ion T r aining or its eq uivalen t . 2 – Level 2: Prototype Transmission Specification (26 May 2015) v1.0 58 XML Tag Data Item / Data Item / Validation OHA/OHR Valid Discontinued Business Description Field Name Mandatory From Rule / Optional Pr ocedur es / condi t ions t o be perf orm ed or m anag ed by a dentist wi t h addi t ional compe t encies[1] but below t he leve l of a pro f essional r ecog nised as a specialist by t he G DC. 3 – Level 3: Pr ocedur es / condi t ions t o be perf orm ed or m anag ed by a pro f essional r ecog nised as a specialist by t he G DC. If Level 3 is selected t he r eason f or doing so m ust be r ecorded as fr ee- t ext adcaspecrea Reason f or Free- t ext O V1 V3 Level Varchar 64 3 r e f err al Recor d t he r eason f or ref err ing t o specialist services
3.4.7 Advanced Care
XML Tag Data Item / Data Item / Validation OHA/OHR Valid Discontinued Business Description Field Name Mandatory From Rule / Optional adc ac at Deter m ine t yp e T ype of n1 O V1 V3 of Ad vanc e d Dr op- do wn l is t: Ad vanc Care ( va l ues 1- 5 are v1 and v2 e d Car e Va l ues 6- 7 are f r om v2) need ed 1 – Ad vanc e d P erio don tal T her ap y 2 – R oot C ana l T her ap y 3 – I ndir ec t Res torat io ns 4 – M eta l Bas ed Part ia l De ntur es 5 - O ther 6 – Pae dod ont ic s Prototype Transmission Specification (26 May 2015) v1.0 59 XML Tag Data Item / Data Item / Validation OHA/OHR Valid Discontinued Business Description Field Name Mandatory From Rule / Optional 7 – M in or Or al Surg er y
If ‘5 – ot her ’ is s e l ec ted the other t yp e of ad vanc e d care nee ded m us t be rec orde d. adcaca t _o t her Ot her Reason Free- t ext O V1 V3 varchar 64 Recor d t he o t her t ype of advanced care r eq uir ed adcalev Level of n1 O V1 V3 Advanced Level of Car e Dr op- down lis t : Care needed 1 – Level 1: Pr ocedur e / condi t ions t o be perf orm ed or m anag ed by a dentist comm ensur ate wit h leve l of com pe t ence as de f ined by t he Curr iculum f or Dental Founda t ion T r aining or its eq uivalen t . 2 – Level 2: Pr ocedur es / condi t ions t o be perf orm ed or m anag ed by a dentist wi t h addi t ional compe t encies[1] but below t he leve l of a pro f essional r ecog nised as a specialist by t he G DC. 3 – Level 3: Pr ocedur es / condi t ions t o be perf orm ed or m anag ed by a pro f essional r ecog nised as a specialist by t he G DC. Prototype Transmission Specification (26 May 2015) v1.0 60 XML Tag Data Item / Data Item / Validation OHA/OHR Valid Discontinued Business Description Field Name Mandatory From Rule / Optional If Level 3 is selected t he r eason f or doing so m ust be r ecorded as fr ee- t ext adcaspecrea Reason f or Free- t ext O V1 V3 Level Varchar 64 3 r e f err al Recor d t he r eason f or ref err ing t o specialist services
Prototype Transmission Specification (26 May 2015) v1.0 61 3.5 Treatment and Clinical Dataset for Prototypes
Check and update patient details during every appointment. Treatment to be linked to patient, performer and contract number. Treatm ent Pro v i ded and Clinical Dataset for Prototypes
A list of treatment codes to be used for treatment items in the pilots is provided in the current version of the document Prototype Treatment cCodes V1.0. Individual treatment codes are not required to be transmitted. At the end of an NHS or mixed NHS/ private CoT summarised treatment is transmitted in accordance with the clinical data set for prototypes as detailed. Where private treatment is provided outside an NHS CoT summarised treatment information is provided at the end of each appointment. Where a clinical data set is required to be transmitted all fields are mandatory. Fields that are not applicable / appropriate for appointments where the appointment type is ‘private’ ie. private treatment unrelated to an NHS CoT but would otherwise be mandatory are shown in column ‘private appointment’ as a default value of ‘PRIVATE’. Where the clinical data set relates to private treatment only default values for fields relating to an NHS CoT are shown in a separate column, ‘ private appointment default value’ in the table.
XML tag Data Data item/Field Validation Mandatory / Private Valid Discontinued Business Item/description Name Optional appoint From Rule ment treapro Treatment/Interim T r eatm ent/Interim Item s of s ervic e code - SD R O V1 V3 Care provided Care Pr o v ide d Dr op- do wn l is t:
Per to oth and per t oot h
surf ac e . T his item is not
requ ir ed if Vers io n 3 of the sp ec if ic atio n is f o l lo wed and t he C ore D ata Set item s are trans m itted. privprov Boolean M V3 23.9, 25.0 Private Has private True PRIVATE 63.2, 63.3 treatment treatment False provided been provided as part of the The private treatment is course of only as an alternative to treatment NHS, i.e.
Prototype Transmission Specification (26 May 2015) v1.0 62 XML tag Data Data item/Field Validation Mandatory / Private Valid Discontinued Business Item/description Name Optional appoint From Rule ment where there is a clinical need.
This question must be answered at the completion of a Course of Treatment. treaprob T r eatm ent/Interim n2 O V1 V3 Care Pr o v ide d By Mult i-s e l ec t Check box 1 – D ent is t 2 – Ex tend ed Dut y De nta l Nurs e 3 – H yg ien is t 4 – Or al Hea lt h Pr om oter 5 – T her ap is t
Per tr ea tm ent pr ov ide d. For eac h tr e atm ent s elec t who it was prov id ed b y.
3.5.1 Clinical Dataset Items
XML tag Data Data item/Field Validation Mandatory / Private Valid Discontinued Business Item/description Name Optional appoint From Rule ment Default Value examination examination Has an Boolean M PRIVATE V3 23.9, 63.0, examinatio True 63 . 1, 63.2, n taken False 63.3 place? If any of the specified codes are present answer ‘True’. 0101
Prototype Transmission Specification (26 May 2015) v1.0 63 XML tag Data Data item/Field Validation Mandatory / Private Valid Discontinued Business Item/description Name Optional appoint From Rule ment Default Value 0111 0121 fp17dcprovide Treatment Plan Has an FP17DC Boolean M PRIVATE V3 23.9, 63.0, d been provided? True 63 . 1, 63.2, False 63.3 dietlifestyle Diet / Lifestyle Has Diet / Boolean M PRIVATE V3 23.9, 63.0, and preventive Lifestyle True 63 . 1, 63.2, , advice advice been False 63.3 given to If any of these codes are patient? present the answer is ‘True’. 3807 3878 3879 3880 3881 3887 radiographs Radiographs taken Number of n2 (> or = 0) M PRIVATE V3 23.9, 63.0, radiograph The cumulative value of all 63 . 1, s taken codes. (e.g. 2x0201 and 63.2, 63.3 1x0204 = 3) 0201 0202 0203 0204 oralhygiene Oral hygiene Has oral Boolean M PRIVATE V3 23.9, 63.0, instruction/tooth hygiene True 63 . 1, brushing instruction / False 63.2, 63.3 instruction tooth If any of these codes are brushing present advice been the answer is ‘True’. given to the 3882
Prototype Transmission Specification (26 May 2015) v1.0 64 XML tag Data Data item/Field Validation Mandatory / Private Valid Discontinued Business Item/description Name Optional appoint From Rule ment Default Value patient 3885 3890 fluorideprescr High Have high Boolean M PRIVATE V3 23.9, 63.0 ip fluoride fluoride True 63 . 1 suppleme supplements False 63.2, 63.3 nts been If either code is present the prescribed answer is ‘True’. 3883 3889 scalepolish Scale and polish Number of n2 M PRIVATE V3 23.9, 63.0, scale and Number of visits 63 . 1, polish / non Where any one of these 63.2, 63.3 surgical codes is present per visit. periodontal 1001 treatments 1011 3886 debridement Root Has root Boolean M PRIVATE V3 23.9, 63.0 surface surface True 63 . 1 debrideme debridement False 63.2, 63.3 nt been provided If any of these codes is present the answer is ‘True’. 4001 is used for follow up root surface debridement so only applies when transmitted with 0601. 1021 3841 4001 (with 0601) fissuresealant Fissure Sealants Number of n2 (> or = 0) M PRIVATE V3 23.9, 63.0 s fissure Number of teeth 63 . 1 sealants Cumulative count of the 63.2, 63.3
Prototype Transmission Specification (26 May 2015) v1.0 65 XML tag Data Data item/Field Validation Mandatory / Private Valid Discontinued Business Item/description Name Optional appoint From Rule ment Default Value provided number of tooth notations where this code is used. 0701 fluoridevarnis Fluoride Varnish Has Fluoride Boolean M PRIVATE V3 23.9, 63.0 h vanish been True 63 . 1 applied? False 63.2, 63.3 If these codes are used then the answer is ‘True’. 0711 fillingsrestorat Permanent Number of n2 (> or = 0) M PRIVATE V3 23.9, 63.0, ions fillings and permanent Number of teeth 63 . 1 sealant fillings and Cumulative count of tooth 63.2, 63.3 restorations sealant notations where one or restoration more of these codes is s used. E.g. if 1401 and 1421 were used at UL2 the value would = 1. If these codes were used at UL1 and UL2 the value would be 2. 1401 1421 1426 1441 crowns Crowns Number of n2 M PRIVATE V3 23.9, 63.0, crowns Number of teeth 63 . 1 provided Cumulative count of tooth 63.2, 63.3 notations where any of
Prototype Transmission Specification (26 May 2015) v1.0 66 XML tag Data Data item/Field Validation Mandatory / Private Valid Discontinued Business Item/description Name Optional appoint From Rule ment Default Value these codes is used. 1711 1716 1722 1726 veneers Veneers and inlays Number of n2 (> or = 0) M PRIVATE V3 23.9, 63.0 veneers and Number of teeth 63 . 1 inlays Cumulative count of the 63.2, 63.3 provided number of tooth notations where either of these codes is used. 1601 1701 upperacrylic Upper Cumulative n2 M PRIVATE V3 23.9, 63.0 acrylic count of tooth Number of teeth 63 . 1 denture notations in Cumulative count of the 63.2, 63.3 the upper number of teeth notations arch used in the upper arch where either of these codes are used. 2731 2733 loweracrylic Lower Cumulative n2 M PRIVATE V3 23.9, 63.0 acrylic count of tooth Number of teeth 63 . 1 denture notations in Cumulative count of the 63.2, 63.3 the lower arch number of teeth notations used in the lower arch where either of these codes are used. 2732 2733
Prototype Transmission Specification (26 May 2015) v1.0 67 XML tag Data Data item/Field Validation Mandatory / Private Valid Discontinued Business Item/description Name Optional appoint From Rule ment Default Value uppermetal Upper metal Cumulative n2 M PRIVATE V3 23.9, 63.0 denture count of tooth Number of teeth 63 . 1 notations in Cumulative count of the 63.2, 63.3 the upper number arch of teeth notations used in the upper arch where any of these codes are used. 2741 2743 2744 2745 lowermetal Lower metal Cumulative n2 M PRIVATE V3 23.9, 63.0 denture count of tooth Number of teeth 63 . 1 notations in Cumulative count of the 63.2, 63.3 the lower arch number of teeth notations used in the lower arch where any of these codes are used. 2742 2743 2744 2745 endodontic Endodon Number n2 (> or = 0) M PRIVATE V3 23.9, 63.0, tic of Number of teeth 63 . 1 treatmen endodonti Cumulative count of these 63.2, 63.3 t of non- c codes at tooth notations molar treatment UL1,2,3,4,5, UR1,2,3,4,5, teeth s at teeth LL1,2,3,4,5, LR1,2,3,4,5. other than E.g. If 1501 molars is used at UL3 and UL2 the value =
Prototype Transmission Specification (26 May 2015) v1.0 68 XML tag Data Data item/Field Validation Mandatory / Private Valid Discontinued Business Item/description Name Optional appoint From Rule ment Default Value 2. 1501 1551 endodonticmo Endodontic Number of n2 (> or = 0) M PRIVATE Pro 23.9, 63.0 lar treatment of molar endodontic Number of teeth V1 63.1 teeth treatments at Cumulative count of this 63.2, 63.3 molar teeth code at these tooth notations: UL8,7,6, UR6,7,8, LR8,7,6, LL6,7,8
1501 extractions Extractions Number of n2 (> or = 0) M PRIVATE V3 23.9, 63.0 extraction Number of teeth 63 . 1 undertaken Cumulative count of 63.2, 63.3 tooth notations where any of these codes are used. 2101 2201 2202 splints Lab made splints Has either a Boolean M PRIVATE V3 23.9, 63.0 or bite raising laboratory True 63 . 1 appliances made splint or False 63.2, 63.3 bite raising If this code is present the appliance been answer provided is ‘True’. 2991 bridgework Bridgework Has n2 (> or = 0) M PRIVATE V3 23.9, 63.0 bridgework Number of units 63 . 1 been provided Cumulative count of the 63.2, 63.3 number Prototype Transmission Specification (26 May 2015) v1.0 69 XML tag Data Data item/Field Validation Mandatory / Private Valid Discontinued Business Item/description Name Optional appoint From Rule ment Default Value of tooth notations where any of these codes are used. 1802 1822 1831 1832
XML tag Data Data item/Field Name Validation Mandatory Valid Discontinued Business Item/description / Optional From Rule privateperio Private Periodontal Has private periodontal Boolean O V3 Pro V1 63.0 treatment treatment been provided as part True 63.1 of the patient’s pathway False If this code is present the answer is ‘True’. 8001 privatescalep Private scaling and Has private periodontal Boolean M Pro 23.9, olish polishing treatment including scaling and True V1 63.263.0 polishing been provided? False 63.1, 63.3 If this code is present the answer is ‘True’ 8000 privatedebrid Private root Has private periodontal Boolean M Pro 23.9, ement surface treatment including root surface True V1 63.263.0, debridement debridement been provided? False 63.1, 63.3 If this code is present the answer is ‘True’
801001 privatefillings Private fillings Have any private fillings n2 M V3 23.9, tr eatm ent been provided? Number of teeth (> or =0) 63.263.0 Prototype Transmission Specification (26 May 2015) v1.0 70 XML tag Data Data item/Field Name Validation Mandatory Valid Discontinued Business Item/description / Optional From Rule 63 . 1, 63.3 Cumulative count of the number of tooth notations where this code is used. 8002 privateendod Private endodontic Have any private endodontic n2 M Pro 23.9, 63.263.0 ontic molartreatment at non- treatments been provided at Number of teeth (> or =0) V1 63.1, 63.3 teeth non-molar teeth? Cumulative count of this code at tooth notations UL5,4,3,2,1 UR1,2,3,4,5 LR5,4,3,2,1 LL1,2,3,4,5 8008 privateendod Private endodontic Have any private molar n M Pro 23.9, 63.263.0 onticmolar treatments at molar endodontic treatments been 2 V1 63.1, 63.3 teeth provided? Number of teeth (> or =0) Cumulative count of this code at tooth notations: UL8,7,6, UR6,7,8, LR8,7,6 LL6,7,8 8008 privateindirect Private Have any private indirect n2 M V3 23.9, indirect restorations been provided as Number of teeth (> or 63.263.0 restorations part of t he pa t ien t ’s pa t hway =0) 63 . 1, 63.3
Cumulative count of the number of tooth notations where this code is used. 8003 privatebridge Private bridgework Has private bridgework been n2 M V3 23.9, provided as part of t he pa t ien t ’s Number of units – (> or 63.263.0 pa t hway =0) 63 . 1, 63.3
Cumulative count of the Prototype Transmission Specification (26 May 2015) v1.0 71 XML tag Data Data item/Field Name Validation Mandatory Valid Discontinued Business Item/description / Optional From Rule number of tooth notations where this code is used. 8004 privatedentur Private dentures Have private denture(s) been n2 M V3 23.9, e provided as part of t he Number of teeth – (> or 63.263.0, pa t ien t ’s pa t hway =0) 63 . 1, 63.3
Cumulative count of the number of tooth notations where this code is used. 8005 privatesplints Private laboratory Has either a private laboratory Boolean M Pro 23.9, 63.263.0 made splints or made splint or bite raising True V1 63.1, 63.3 bite raising appliance been provided? False appliances If this code is present the answer is ‘True’ 8009
8009 privatepr even Pr ivate preven t ion Has any private preven t ion Boo lean O V3 Pro V1 63.0, 63 . 1 t ion tr eatm ent been provided as True part of t he pa t ien t ’s pa t hway False If this co de is prese nt t he answe r is ‘True’. 8 00 6
This is treatm ents invo lving fissure sealants, fluo ride applicatio ns and OHI / dietary adv ice.
Prototype Transmission Specification (26 May 2015) v1.0 72 XML tag Data Data item/Field Name Validation Mandatory Valid Discontinued Business Item/description / Optional From Rule privatefissure Private fissure Number of private N2 (> or =0) M Pro 23.9, 63.263.0 sealants sealants fissure sealants Number of teeth V1 63.1, 63.3 provided Cumulative count of tooth notations where this code is used.
80 12 07 Privatefluorid Private fluoride Has private fluoride Boolean M Pro 23.9, 63.263.0 etreatment varnish or varnish or other True V1 63.1, 63.3 treatment fluoride treatment False been provided? If this code is present the answer is ‘True’
80 11 06 privateother Private other Boolean M Pro Has any other private treatment True V1 23.9, been provided as part of the False 63.263.0 patient’s If this code is present the 63.1, 63.3 pathway answer is ‘True’. 800710 Privateindirec Private indirect Have any private crowns been N2 Number of teeth (> or = M Pro 63.2 tcrowns restorations provided 0) V1
Cummulative count of number of tooth notations where this code is used.
8014 privateindirect Private indirect Have any private indirect N2 Number of teeth (> or = M Pro 63.2 other restorations other restorations, excluding crowns 0) V1 than crowns been provided? Cummulative count of number of tooth notations Prototype Transmission Specification (26 May 2015) v1.0 73 XML tag Data Data item/Field Name Validation Mandatory Valid Discontinued Business Item/description / Optional From Rule where this code is used.
8015
privateextracti Private extractions Have any extractions been N2 Number of teeth (> or = M Pro 63.2 on provided privately? 0) V1
Cummulative count of number of tooth notations where this code is used.
8013 3.5.2 Referral
XML tag Data Data item/Field Name Validation Mandatory Valid Discontinued Business Item/description / Optional From Rule r e f err edto Re f err al T r eatm ent/Interim n1 M V1 V2 Care re f err ed to Dr op- do wn l is t: 1 – Pr im ar y C are Speci a l is t 2 – Sec on dar y Care Sp ec ia lis t 3 – Sa l arie d Serv ic es 4 – O th er: p leas e s t ate r e f err alSpec Re f err al s pec ia l t y Re f err al s pec ia l t y n2 O V1 V3 i alt y 1.Primary Care – T r eatm ent/Interim Restorative Care re f er r ed to 2.Primary Care – Endodontics 3.Primary Care – Periodontology
4.Primary Care – Minor Oral Surgery
Prototype Transmission Specification (26 May 2015) v1.0 74 XML tag Data Data item/Field Name Validation Mandatory Valid Discontinued Business Item/description / Optional From Rule 5.Primary Care - Oral Medicine 6.Primary Care - Consultant led orthodontics
7.Primary Care - Paediatric referrals 8.Primary Care - Specialist Orthodontic Practitioners 9.Secondary Care – Restorative
10.Secondary Care – Endodontics 11.Secondary Care - Periodontology 12.Secondary Care - Oral and Maxillofacial Surgery
13.Secondary Care - Oral Medicine 14.Secondary Care - Consultant led orthodontics 15.Secondary Care - Paediatric
16.Secondary Care – Prosthodontics 17.Secondary Care – Prototype Transmission Specification (26 May 2015) v1.0 75 XML tag Data Data item/Field Name Validation Mandatory Valid Discontinued Business Item/description / Optional From Rule Temporomandibular Disorders 18.Secondary Care – Implants
19.Special Care/Salaried services - GA 20.Special Care/Salaried services – Dental Phobic 21.Special Care/Salaried services – Medically Compromised 22.Special Care/Salaried services - Behavioural management problems 23.Special Care/Salaried services - Mobility 24.Other
If ‘Other’ the other specialist service referred to must be recorded as free text. r e f err edT oOt O ther s pec ia l is t or s ervic e Free-text O V1 V3 her re f err ed t o varchar 64 r e f r eas Re f err al Reas o n n1 O V1 V3 Dr op- do wn l is t:
Prototype Transmission Specification (26 May 2015) v1.0 76 XML tag Data Data item/Field Name Validation Mandatory Valid Discontinued Business Item/description / Optional From Rule 1. Sec on d o pin io n 2. Ad vic e & T r eatm ent Pla nn ing 3. T r eatm ent
Prototype Transmission Specification (26 May 2015) v1.0 77