Are we Getting It Right First Time? An exploration of clinical coding practices within a UK paediatric dental hospital department

Introduction Issues arising from the current coding system in dentistry have been highlighted. Available codes are considered to lack clarity and fail to reflect all dental specialties. There are no paediatric-specific codes, which means codes from other specialties are used, which may not accurately reflect the work carried out.Aim This paper aims to explore the range of codes and the consistency and accuracy of current coding practices within the paediatric dentistry department at Newcastle Dental Hospital, and explore the potential impact of introducing new speciality-specific codes for the aforementioned procedures.Method Data were retrospectively collected to determine whether the following treatments had been undertaken, and if so, which procedure code had been used for the treatment: inhalation sedation; dietary advice; acclimatisation; preformed metal crowns, silver diamine fluoride application; and apexification. All codes used within the department for a six-month period were also reviewed retrospectively and the frequency in which procedures relating to the potential new codes would be undertaken within the department was estimated to facilitate consideration of potential financial impact of the introduction of new codes.Results Codes utilised for the aforementioned procedures did not accurately reflect work carried out despite being relatively consistent. The potential new codes corresponded to procedures that were commonly undertaken within the department.Discussion This study highlights shortcomings in the coding system relating to a lack of applicable codes for paediatric dentistry procedures. Introduction of new speciality-specific codes should help to address this deficit to ensure a more accurate representation of the needs of the community to help commissioning and workforce planning. Coding in paediatric dentistry is essential to allow effective commissioning and workforce planning.The recent Getting It Right First Time report highlights shortcomings within the current coding system, including a lack of applicable codes to numerous paediatric dentistry procedures.This paper highlights how introduction of new paediatric dental-specific codes can better reflect clinical practice and improve representation of the needs of the community to help commissioning and workforce planning.

Automated summary

This study examines the issues with the current coding system in paediatric dentistry and explores the potential impact of introducing new specialty-specific codes. The findings show that the existing codes do not accurately reflect the work carried out, and the introduction of new codes can improve the representation of community needs and help with commissioning and workforce planning.