Dental Reference Officer (DRO) examination codes

The codes used on the reports from the Dental Reference Officers (DRO’s) have the following meaning:

For a post treatment case administrative Codes 1, 2, 3, 4 are used to demonstrate the DRO’s opinion of the clinical care and treatment in order to define what the DRO believes should occur subsequently.

For a pre-treatment case administrative Codes A, B, C, D are used to demonstrate the DRO’s opinion of the clinical treatment proposals in order to define what the DRO believes should occur subsequently.

The above codes are used only to define the clinical work; none are used in relation to clerical concerns, possible misclaims, potential prior approval violations, or treatment possibly not in accordance with the regulations.

Administrative Codes 1 and A define that in the opinion of the DRO the treatment and / or the treatment proposals are satisfactory.

Administrative Code 2 defines that the DRO confirms that

a) The treatment carried out was satisfactory at completion and something minor is amiss at the time of examination (for example, a restoration has been lost) or

b) The DRO believes the treatment was satisfactory at completion but requires further information to be sure (for example. the practitioner has not submitted a final root treatment radiograph to confirm that the canal has been satisfactorily obturated).

Administrative Code B defines that the DRO believes the treatment proposals are broadly satisfactory but is asking the practitioner to consider a minor change to the treatment proposals.

Administrative Code 3 or Code C define that the DRO has concerns related to the clinical care provided or proposed and is requesting that Practitioner Services carry out further investigations related to the findings. (This would result in Practitioner Services seeking further information from the practitioner and possibly referring further patients to the Dental Reference Service to give assurance of clinical appropriateness).

Administrative Code 4 or Code D defines that the DRO has concerns related to the clinical care provided or proposed that are of such concern that, after receiving further information from the practitioner, the matter should be discussed with the NHS Board so that Practitioner Services and the NHS Board jointly can decide on the nature of the investigation that should subsequently be carried out in order to give surety regarding the practitioner’s clinical abilities and to define what should then if anything further should occur.

Non Clinical Codes (i)

In cases where there are concerns related to possible clerical errors, misclaims or regulatory concerns, the administrative code i is used as a prefix and upon receipt of information from the practitioner will be recorded as either:

Administrative i (m): possible misclaim (an example would be claiming the wrong code).

Administrative i (c): possible clerical error (an example would be mixing an upper and a lower or left and right on the charting of a restoration).

Administrative i (r): possible regulatory error (an example would be claiming an amalgam on the occlusal surface of a premolar when a composite was provided.)

Dependent upon the information received, an “i“ code might result in no further action, further DRO examinations, discussions with or referral to the NHS Board or in some cases where it is considered appropriate in addition to referral to the NHS Board referral to NHS Counter Fraud Services.

Possible Prior Approval Violations

An administrative code P as a suffix is used where the DRO considers that prior approval regulations may not have been observed.

This code may result in discussions with the NHS Board and consideration by the Dental Advisers regarding what should subsequently occur.

Dentist Carrying Out the Treatment

The report should clearly record the dentist who carried out the treatment is (i.e. a VDP or assistant) where a dentist other than the dentist whose contract is being used carries out the treatment.