Genesis Health System, Davenport, IA, USA.
University of Iowa, Iowa City, IA, USA.
J Prim Care Community Health. 2020 Jan-Dec;11:2150132720913736. doi: 10.1177/2150132720913736.
Dental caries is the most common chronic disease in children from birth through 5 years of age. Application of fluoride varnish (FV) is recommended for children younger than 6 years every 3 to 6 months by the United States Preventive Services Task Force. The purposes of this study were to (1) assess use and reimbursement of Current Dental Terminology (CDT) D1206 and Current Procedural Terminology (CPT) 99188 codes, which are the billing codes for FV application; (2) determine when and by whom each FV code was used; and (3) summarize the associated clinical notes. Using the electronic medical record data warehouse from a single tertiary teaching hospital and its affiliated primary care clinics, the dates of service, departments, provider names, and patient identifiers associated with codes CDT D1206 and CPT 99188 were collected. The content of clinical notes was reviewed and summarized. The study period was from May 1, 2009 through May 17, 2019. During the 10-year time period, CDT D1206 was used 5 times and CPT 99188 was used 35 times. FV was applied exclusively during well-child visits. Only pediatricians, and no family physicians, applied FV in this setting. A single pediatrician championing for FV application increased both the completion of procedure and the appropriate billing in 2019. FV application has been likely underutilized in this Midwestern tertiary teaching hospital and its affiliated clinics. For both family medicine and pediatric offices, an advocate for caries prevention is likely needed for successful implementation of FV application at well-child visits.
龋齿是 0-5 岁儿童最常见的慢性疾病。美国预防服务工作组建议，6 岁以下儿童每 3-6 个月应用氟化物涂料（FV）。本研究的目的是：（1）评估当前牙科术语（CDT）D1206 和当前程序术语（CPT）99188 编码的使用和报销情况，这些编码是 FV 应用的计费编码；（2）确定每个 FV 编码何时以及由谁使用；（3）总结相关的临床记录。使用单一三级教学医院及其附属初级保健诊所的电子病历数据仓库，收集与 CDT D1206 和 CPT 99188 编码相关的服务日期、科室、提供者姓名和患者标识符。审查和总结临床记录的内容。研究期间为 2009 年 5 月 1 日至 2019 年 5 月 17 日。在 10 年期间，使用 CDT D1206 5 次，CPT 99188 35 次。FV 仅在儿童健康访视时应用。只有儿科医生，没有家庭医生，在这种情况下应用 FV。2019 年，一位倡导 FV 应用的儿科医生增加了该程序的完成情况和适当的计费。FV 的应用在这家中西部三级教学医院及其附属诊所可能没有得到充分利用。对于家庭医学和儿科办公室，需要有一位龋齿预防的倡导者，才能在儿童健康访视时成功实施 FV 应用。
