NHS Wales April 1st Changes - CCN47

Changes to NHS Wales claims following regulatory updates from 1st April 2022

Kevin Bell avatar
Written by Kevin Bell
Updated over a week ago


CCN47 (Change Control Note) comes into effect for NHS Wales practices from 1st April 2022. For Dentally users, this also means that NHS Wales sites will move onto our new NHS Claim screens. These screens have been redesigned to make the process of submitting claims quicker and easier as well as to encompass the changes required.

As part of implementing these new screens, we have also changed how practices record ACORN assessments; moving the recording of the ACORN data to a treatment plan item instead of recording the results on the NHS Claim. This change is the result of customer feedback, allowing users to record the ACORN assessment details required as part of an NHS claim earlier in the process. This change does now require practices to use an ACORN assessment treatment item from their list of available treatments where an ACORN assessment was carried out. This ACORN assessment treatment must be added to the practice's list of available treatments before 1st April 2022 - or where the practice has already created and ACORN assessment treatment, the new NHS Treatment category should be applied. There are details of the settings changes required and how to use this new assessment treatment lower in this article.

New Treatment items:

As in previous NHS changes, there have been new NHS Treatment Categories added which can be used from April 1st 2022. These will mostly require new treatment items to be added to your list of treatments, although some of the changes require only additional options for you to select when submitting a claim. You can, of course, number and name these new treatments as you wish, but importantly, the correct NHS Treatment Category and UDA Band should be set. These new treatment items can be created now, but should not be used until submitting a claim with a start date on or after 1st April 2022.

Below is a list of the new items included in the changes being introduced from 1st April 2022 with our advice on how to implement the required changes to your treatments list.

If you are unsure how to add treatments to your list, please see our help article here.

New Items: Metal Dentures

Metal Dentures: New Treatment Categories

Band

Upper Denture - Metal

3

Lower Denture - Metal

3

Dentally Advice:

In a previous change, these codes were removed and replaced with a single metal denture code for both upper and lower dentures. The separate codes have been re-introduced and practices will need to ensure they have 2 separate treatments for upper and lower metal dentures with the appropriate codes and banding applied. These codes can only be used on treatment plans starting 1/4/22 or after.

Note: Metal Dentures using the old single code for treatment plans started before 1/4/22 will need to be retained and use the old code - you must create new treatments and retain the original upper/lower metal denture code for these older treatment plans.

New Items: Cleaning and Instruction

Cleaning and Instruction. The code 9333 (Tooth Brushing Instruction) is to be discontinued and fragmented into four new codes as follows:

Cleaning and Instruction: New Treatment Categories

Band

Removal of Plaque Retentive Factors

1

Toothbrushing Advice

0

Interdental Cleaning Aids

0

Oral Hygiene Improvement Plan

0

Dentally Advice:

Practices will need to create these new treatment items in Dentally and apply the appropriate NHS Treatment Category and Banding to each. These codes will not be sent for treatment plans started before 1/4/22. The removed item 9333 will not be sent for claims started after 1/4/22 and the appropriate new option should be used instead.

New Items: Virtual Consultation and Treatments Offered

Consultation and Treatments Offered: New Treatment Categories

Band

Virtual Consultation Provided as Part Of the Course of Treatment

0

Caries Treatment Offered but Further Self Care Improvement Required

0

Perio Treatment Offered but Further Self Care Improvement Required

0

Dentally Advice:

Practices will need to create these new treatment items in Dentally and apply the appropriate NHS Treatment Category and Banding to each. These codes will not be sent for treatment plans started before 1/4/22.

New Items: Prescribed items

The Prescription only treatment code 9158 is no longer applicable from 1/4/2022 and instead, practices should state the prescribed items from the new categories below.

Prescribed Items: New Treatment Categories

Band

Prescribed Items - Antibiotic

0

Prescribed Items - High Fluoride Toothpaste/Daily Rinse

0

Prescribed Items - Oral Hygiene Mouthwash

0

Prescribed Items - Oral Medicine Mouthwash/Sprays

0

Prescribed Items - Analgesics

0

Prescribed Items - Antifungals/Antivirals

0

Prescribed Items - Sedatives

0

Prescribed Items - Artificial Saliva Products

0

Dentally Advice:

Practices will need to create these items as new treatments in Dentally and apply the appropriate NHS Treatment Categories. These codes will not be sent for claims where the treatment plan started before 1/4/22

New Items: Endodontic Treatment

The old code 9305 (Endodontic Treatment) will be discontinued for Wales and replaced with:

Endodontic Treatment: New Treatment Categories

Band

Endodontic Treatment - Molar

2

Endodontic Treatment -Non-Molar

2

Dentally Advice:

Practices will need to create these new treatment items in Dentally and apply the appropriate NHS Treatment Category to each. These codes will not be sent for treatment plans started before 1/4/22. The removed item 9305 will not be sent for claims started after 1/4/22. Practices must create a Molar and Non-Molar code and apply the appropriate code when charting this treatment.

Screenshot 2022-03-18 at 14.57.56.png

New Items: Extractions

The old code 9307 (Extraction) will be discontinued for Wales and replaced with:

Extractions: New Treatment Categories

Band

Non-surgical Extraction

2

Surgical Removal of Teeth

2

Dentally Advice:

Practices will need to create these new treatment items in Dentally and apply the appropriate NHS Treatment Category to each. These codes will not be sent for treatment plans started before 1/4/22. The removed item 9307 (Extraction) will not be sent for claims started after 1/4/22.

Screenshot 2022-03-18 at 14.59.06.png

New Items Required which will be displayed on the NHS Claim Screens:

From April 1st, you will have access to our new NHS Claim screens. We have re-designed the screens you use to help make submitting NHS claims, quicker and easier. Claims raised which started before 1st April 2022 on these new screens will contain no new options, but will use the new layout. Claims starting on or after 1st April 2022 will also contain the new options below:

New Item: Plaque Score:

There are 3 options to select here:

1 - Low

2 - Moderate

3 - High

New Item: Patient Presented With:

1 – Routine Visit

2 – Pain/Infection

3 – Other/Advice

This is a Mandatory field and an option must be sent with every claim. The default setting is 'Routine Visit' but this should be changed where appropriate.

New Item: Inclusion of BPE:

Basic Periodontal Exam (BPE) Sextant Scores and furcation involvement can now be sent along with a claim. Where the patient has a recent BPE recorded, this will be automatically added to the claim. New BPEs can also be recorded from the claim screen. Where a BPE is shown on the claim screen, it will be included in the claim submission.

The Claims screen allows recording of a new BPE at the point of creating a claim:

BPE recording screen:

New BPEs recorded when submitting a claim will also be recorded in the BPE section of the patient's Chart screen.

Where a BPE has been saved for this patient on or after the start date of this treatment plan, this BPE will be automatically included, or a new BPE can be recorded where appropriate. Where the BPE attached to this claim was created within the last 24 hours, the BPE can be updated here too.

New Items: Delivering Better Oral Health:

The following items constitute the best practice advice given to the patient. All are presented as tick box options when submitting the claim and require no settings changes by the practice to implement. These options will be presented on claims submitted with a start date on or after 1/4/2022:

Better Oral Health: New Items

Dietary Changes Agreed

Brief Intervention in Smoking/Tobacco Use and Referral

Brief Intervention in Alcohol Use and Referral

Advice on Fluoride Toothpaste and Spit No Rinse

Changes to ACORN and non ACORN Exams

A Routine Exam and ACORN Exam are now mutually exclusive, a claim cannot contain both. Where an ACORN exam has been completed, the relevant ACORN assessment details will be sent along with a 9179 ACORN assessment code.

Where a Routine Exam has been completed and not an ACORN exam, a Routine Examination should be charted.

Where no Examination has been completed, a reason for there being No Examination of any kind should be selected and sent.

Dentally Advice:

We now require practices to chart an ACORN Assessment treatment on the treatment plan along with your other treatments.

A new treatment category has been created which will enable your treatment items to record ACORN details when this option is applied to a treatment.

Practices must create an ACORN Assessment treatment and apply the NHS Treatment Category ACORN Assessment and a Band 1 weighting.

If you have already created and use a treatment item to record ACORN assessments, this can be used too, but must now have the NHS Treatment Category and UDA Band 1 set. Your existing treatment settings, such as Custom Fields will remain in place.

Once this setting has been applied to a treatment and this treatment charted, this will then allow the user to record the ACORN assessment details against the treatment plan item on the plan. When an ACORN Assessment is charted, this recordings screen will be displayed in the treatment plan:

This new treatment plan item allowing the recording of ACORN assessment details can be applied to any NHS claim, where an ACORN assessment has been carried out and can be used on treatment plans starting before or after 1/4/2022. If you previously charted a treatment plan item which has now been set to record ACORN details, this item will need to be re-charted in order to record the results.



The ACORN Assessment details can be recorded here at any point during the treatment plan in the same manner as writing notes or using Custom fields. These details carry through to the ACORN Assessment area on the Claim:

NOTE: Where there is no ACORN Assessment treatment on the plan, the ACORN data cannot be recorded when submitting the claim as before. Practices must have this ACORN treatment and chart this treatment on the treatment plan wherever an ACORN is carried out.

No Examinations Carried Out:

Where there are no Exams of either kind on a claim, the practice must record a reason for no exam being present. This is recorded on the claim screen by a drop down menu which is only displayed where there is no Exam of either kind on the treatment plan. This translates to an Exam code with the following options added:

  • Exam not Possible

  • Exam not Necessary (ie, Exam not due or claim was part of an Urgent or non-banded course)

Where this appears, it is mandatory and a reason must be selected before a claim can be sent.

Other Changes:

ACORN data not allowed on Urgent claims:

Where a claim is band 4 (Urgent), no ACORN data will now be sent, even if an ACORN assessment has been charted on the treatment plan.

Charge Exempt Items:

If a charge exempt item (Prescription Only, Repairs to Dentures, Repairs to Bridges, Arrest of Bleeding and Removal of Sutures) is entered on a banded claim it is normally dropped from the claim with a general comment “Charge Exempt Ignored”. From 01/04/22 five new comments will be introduced to show specifically what Charge Exempt item was dropped.

278 Prescription Only Ignored

279 Repairs to Dentures Ignored

280 Bridge Repairs Ignored

281 Arrest of Bleeding Ignored

282 Removal of Sutures Ignored

Dentally Advice:

No change required here - NHSBSA will send updated error messages.

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