Following the introduction of the changes for Dental Care Professionals (DCPs) to provide courses of dental treatment as Direct Access Clinicians we have noticed significant rejection rate for these claims.
If you have received details for errored submissions with codes 513, 514 or 515, this is because the information submitted around the DCP is incorrect and has resulted in an error.
A few tips are as follows:
- Please note that your Dental Practice Management System submits a code for the type of involvement a DCP has on a course of dental treatment.
- Where a DCP opens the course of treatment as a Direct Access Clinician, this will include code 9182 with the activity submission.
- Where a DCP is assisting on a course of dental treatment opened by a Dentist Clinician, this will include code 9178 with the activity submission.
- Where a DCP is assisting on a course of dental treatment opened by a Direct Access Clinician, this will include codes 9178 and 9182 with the activity submission.
If you are encountering problems with your activity submissions, following information may help to prevent this in future.
There are three possible situations that includes DCP involvement.
- Where a Dentist Clinician opens a course of treatment, but a DCP assists or does part of the treatment (or where a DCP does all of the treatment but does not have a tenure with that contract). The activity needs to include the dentist's personal ID, the GDC number of the DCP concerned the DCP type (Dental Therapist, Dental Hygienist, Dental Nurse or Clinical Dental Technician). This will be submitted with code 9178.
If in such cases code 9182 is submitted it will reject with error code 513 because 9182 suggests that the personal ID belongs to a DCP. - Where a Direct Access Clinician opens and completes the whole course of treatment and has their own tenure under the contract. The activity needs to include the Direct Access Clinician’s personal ID for the Direct Access Clinician type (Dental Therapist, Dental Hygienist or Clinical Dental Technician). This will be submitted with code 9182.
If code 9182 is omitted from the submission it will reject with error code 515 because this is mandatory where the personal ID belongs to a DCP.
Code 9178 and the DCP’s GDC number is not required on these submissions. - Where a Direct Access Clinician opens a course of treatment and has a tenure under the contract but has another DCP assisting or doing part of the treatment. The activity submitted needs the Direct Access Clinician’s personal ID for that Direct Access Clinician type (Dental Therapist, Dental Hygienist or Clinical Dental Technician). This will be submitted with code 9182.
This submission also needs to include the GDC number of the assisting DCP with the DCP type of the assisting DCP (Dental Therapist, Dental Hygienist, Dental Nurse or Clinical Dental Technician). This will be submitted with code 9178.
If code 9182 is omitted from the submission it will reject with error code 515 because this is mandatory where the personal ID belongs to a DCP.
You should also be aware that the value entered and transmitted with code 9182 as the DCP Type must match with the known speciality or specialities of the DCP concerned. If it does not then the submission will reject with error code 514.