The Charting Menu is used to select dental procedures to be applied to a patient's chart. This article covers how to access the Charting Menu inside the Dental Tab, and what each function inside the Charting Menu does for you.
Accessing the Charting Menu
The Charting Menu can be accessed by right clicking on a tooth on a patient's chart when on the Patient Chart, Treatment Plan, or Completed Procedure nodes in the Incident Sidebar of the Dental Tab, located inside the Patients Ability.
When you right click a tooth, that tooth will be highlighted to indicate the tooth that you're currently charting for. Alternatively, if you wish to chart a procedure without indicating a tooth, you can use the "Chart Without Tooth" button located at the top of the patient chart.
Before using the charting menu, it is important to select the correct node in the Incident Sidebar to ensure that procedures are placed within their proper context. For example:
Procedures that were completed outside of the office should be recorded in the Patient Chart node, which is typically used for historical procedures.
Procedures completed in the office should be charted within the Completed Procedures node.
Procedures that are planned for the future should be charted under the Treatment Plan node.
Let's break down each selection in the Charting Menu.
Charting Menu Selections
All
All under the charting menu will show a table view which allows the user to search for a procedure within the selected fee schedule. This is best used when you know the specific procedure code you wish to chart, or the specific name of the procedure.
The Fee Schedule drop down allows you to select an appropriate fee schedule that should be used for the patient's record. By default, the fee schedule set in the Patient tab will automatically be selected.
The Provider field allows you to set the provider responsible for the charted procedure. This also defaults to the Provider set in the Patient tab.
The Tooth field indicates the Tooth number you're currently charting for. If this is not the correct tooth number, cancel this window and right click again to select the correct tooth. Procedures such as an exam or radiology visit will require the tooth number to be empty, and thus the "Chart Without Tooth" button should be utilized.
Once the code has been selected, click OK to add this graphic to the chart and add a line item to the Clinical Notes Table.
Toggle Missing
Missing teeth can be graphically removed with the Toggle Missing node in the Charting Menu. This option should not be used for teeth that have been extracted. Simply select Toggle Missing and the tooth will be removed from the chart.
When a tooth is toggled as missing, a Clinical Note entry will be created in the Clinical Note Table. Additional information can be added to this note. If a tooth should not be marked as missing because it has grown back in, simply select the entry from the Clinical Note Table and press the delete key on your keyboard to remove it.
Extraction
The Extraction option in the Charting Options Menu displays all extraction codes in the selected Fee Schedule. The codes that are showing in this menu will depend on the Charting Code Map. Select the correct extraction code and click the Ok button.
Selecting an extraction code for any tooth will remove the tooth graphic from the patient's chart and the EXT flag will be placed underneath the tooth number. A colored X can be displayed on the tooth to identify if the extractions was completed outside of the office, completed in the office, or treatment planned for the future. This feature must be enabled through the charting option menu.
Teeth that have been extracted will be recognized as non-existing teeth. If an additional extraction code is added to the tooth, MacPractice will present a prompt stating that You're trying to extract a non-existing tooth. Click the OK button to cancel the duplicate extraction.
Attempting to post a procedure to an extracted tooth will also result in a warning. This warning will require approval of the procedure before it is saved. Click the OK button to proceed with adding the procedure to an extracted tooth. To bypass this warning for the selected tooth, check the box next to Don't ask me again.
Extracting a Supernumerary
Sometimes a Supernumerary will need to be extracted from the patient. A supernumerary must be added to the patient's chart by using the Supernumerary node in the charting menu. Once this supernumerary has been added, right click on the tooth and navigate to the extraction node. Simply check the box notating that the supernumerary is being extracted and complete the rest of the extraction steps above.
Surface Restoration
Selecting Surface Restoration allows you to chart Surface Restorations on the right-clicked tooth. Before interacting with the Surface Restoration, you'll need to ensure you've selected the correct Fee Fee Schedule, Provider, and Tooth before choosing surfaces and materials.
The graphical representation of the tooth is used to display and select the surfaces that are being restored. Simply check the boxes below the image to highlight the selected surface on the tooth. The surface itself can be selected on the tooth to check the corresponding boxes. If needed, use the radio buttons to switch the tooth view between Facial, Occlusal, and Lingual. All of the surfaces can be quickly selected or deselected by using the buttons below the checkboxes.
Once all of the surfaces have been selected, select the material or type of restoration. Notice that as a material is chosen the graphic display will change to update the color. Continue though the selections on the right of the menu. The available materials for any procedure as well as whether the code is an Inlay or Onlay code, will be determined by the mapping of the selected Fee Schedule in the Charting Code Map. Notice that as each selection is made, the details at the bottom of the screen are updated to show what will be placed on the patient's chart.
Every once in a while, a surface restoration and material might have multiple procedure codes to choose between. MacPractice allows the user to select the correct procedure from this window by clicking and holding on a button within this panel. If multiple procedures are available for a material, MacPractice will display the options in the form of a drop down. Simply select the correct code from the list to see the updated details. Click OK to add this procedure to the patient's chart.
Crowns
The Crowns option in the Charting Options Menu can be selected to apply a crown of a specified Crown Type and Material to any tooth. Start by verifying the correct fee schedule and provider. This information will pull forward from the patient's demographics.
Once the Fee Schedule and provider have been selected, click the crown type from the listed options. Available material will show once a type has been chosen. Some materials will be greyed out or not available with the selected crown type. Use the Charting Code Map to activate materials that are needed in the office.
Notice that the bottom of the charting window will display the code, short description and the price for the patient. Sometimes an office will have multiple procedures for the same type and material of crown. When this is the case, simply click and hold on the material to see a drop down with a list of different procedure options. The Charting Code Map will need to have both of these procedures entered into the correct folder to use the drop down while charting.
Once everything has been selected, click okay to add the crown onto the patient's chart. Notice that the crown will be outlined in color based on the chart selected in the incident window (blue for patient chart, green for completed procedures, or red for treatment plans).
Root Canal
The Root Canal option in the Charting Options Menu displays the root canal codes in the selected Fee Schedule that were added by the Charting Code Map. Codes that can not be used on the selected tooth will be displayed in a light grey color. Select the correct root canal code and click the Ok button to add this procedure into the patient's chart.
Bridge/FPD
At least two teeth need to be selected to use the Bridge/FPD node within the charting menu. Two teeth can be selected by left clicking and dragging a box around the selection. Once the teeth are highlighted, right click to open the charting menu.
Start by selecting the crown type within the charting menu. MacPractice will allow the user to select between full and partial crown.
Once the type has been selected, move to the material and choose from the present options. This field will change based on the options entered into the charting code map.
Notice how the selected teeth change while selections are being made to the type and material. Selecting a tooth will allow the user to mark if it is a retainer or a pontic tooth. The selection to skip the tooth is also present for this charting.
The table below the graphic will update to display the codes that will be added to the patient's record. These codes can be adjusted, added to, or removed within the table. Once complete click OK to add this graphic to the chart and to add a line item to the clinical notes table.
RPD
To enter charting through the RPD option in the Charting Options Menu, select three or more teeth. If less than three teeth are selected, the Charting Options Menu will present the message Select at least 3 teeth.
Once three teeth are chosen, ensure that the correct fee schedule and provider have been selected. Both of these drop downs will pull forward from the patient demographic tab.
Next select the type of crown by making a selection from the list. Notice how the material colors change as the selection changes. Once the selection is complete, confirm that the correct code is being used at the bottom of the screen.
The structure of the bridge can also be redefined. Select any tooth and choose Skip, Clasp, or Tooth. Once complete click the Ok button to add the RPD to the patient's chart.
Exam and Radiology
The Exam & Radiology option lists all codes from the selected Fee Schedule relating to tooth exam and radiology that have been entered in the Charting Code Map. MacPractice does not display a graphic for an exam or radiology visit. A clinical note will be added to the Clinical Note Table for details on the exam or the radiology visit.
Implant Service
The Implant Service option in the Charting Options Menu lists the implant codes that are in the selected fee schedule. This menu will show all the codes that were entered in the Charting Code Map.
Select the desired code and click the Ok button to add the implant graphic into the Charting View. Additional codes can be added on the fly by selecting the button Add more Implant codes. All of the codes within the selected Fee Schedule will display. Select the desired code and click the Ok button to add the code.
If you're looking to add a Crown, we recommend adding it into the appropriate Charting Code Map entry in the Managers Ability, so it appears as a Crown and not an Implant.
Posts and Core
The Post & Core option in the Charting Options Menu lists the post & core codes that are in the selected fee schedule. This menu will show all the codes that were entered using the Charting Code Map.
Selected the desired code and click the Ok button to add the post or core graphic into the Charting View. Additional codes can be added on the fly by selecting the button Add more Post codes. All of the codes within the selected Fee Schedule will display. Select the new code and click the Ok button to add the code.
Tooth Conditions
The Tooth Condition option in the Charting Options Menu is used to add additional graphical information on the selected teeth. Tooth conditions, drift, or rotation of a tooth can be added, as well as an accompanying Clinical Note. Before adding any information, confirm that the correct provider has been pulled into the Charting Menu.
Abrasions, Abscess Roots, and Fractured Teeth
Abrasion, Abscess Root, and Fractured Tooth are predefined Tooth Conditions that can be selected to impact the tooth graphically. Simply select the condition and click OK. MacPractice will immediately place a graphical condition onto the selected tooth.
The graphic for a tooth condition can be changed by clicking on the tools to the right. This will switch the screen to the annotation view. This view will function the exact same as the Annotate option from the Charting Menu. Not only can a tooth condition be changed, but also, additional conditions can be added by clicking the green plus at the bottom of the charting view. Graphics can be added for Facial, Occlusal, or Lingual perspectives by selecting the corresponding tab. Be sure to enter in a code and a description at the top of the screen before saving the new condition.
Clinical Note
The New Clinical Note On Clicking Ok field is a free field note box used to enter additional information about the selected tooth. This box is generally used in conjunction with another selected Tooth Condition in order to add additional information about the Tooth Condition being charted. Any information that is entered into this field will be saved into the Clinical Note Table.
Drift and Rotation
The Drift and Rotation menu is used to change the graphical orientation of a tooth. Clicking a button once will make one change to the tooth. Click multiple times to drastically move the tooth on the patient's chart. To undo a drift or rotation, simply click the opposite button within this menu.
The arrow buttons will move the tooth up and down, and side to side. Continue clicking an arrow to move the tooth further in one direction.
The Rotation Arrows will change the direction of the tooth rotation based on the button that is selected. Click the button multiple times to drastically change the appearance of the chart.
The Orientation Arrows will rotate the tooth graphic 45 degrees to the direction in which the orientation arrow is pointing. This orientation can only be moved 45 degrees.
Sealants
The Sealants option in the Charting Options Menu lists the sealants procedure codes mapped within the Charting Code Map for the selected Fee Schedule. Verify that the correct Fee Schedule and Provider have been chosen before charting the sealant.
Charting a sealant on the selected tooth is simple. Use the checkboxes to mark the surfaces that were sealed on the tooth. A user can also click the surface on the graphical tooth. This will check the corrosponding checkboxes. Notice that there are two buttons on this page, Set All Surfaces and Clear All Surfaces. These are used to quickly select or deselect all the surfaces on the tooth.
Once the correct surfaces have been selected, choose the correct sealant procedure from the table below. Use the Charting Code Map to add additional codes to this table if needed. The sealant will place a colored S in the middle of the tooth. The same S will be displayed for a sealant on one surface, as well as on all surfaces. Use the Clinical Note Table to see which surfaces were sealed during this procedure. Click the OK button to add this procedure to the patient's chart.
Caries/Defective
Caries and Defective Restorations can be recorded within the patient's account. Charting caries and defective restorations will place a graphical display onto the dental chart and a clinical note into the clinical note table.
The options for this selection are quite simple. MacPractice will automatically pull the patient's provider from the demographics tab. This can be changed on the fly to the provider that is notating the decay or the defect. The number will also display the tooth that is selected within the chart. This can be changed by closing this window and selecting the correct tooth if needed.
Start by marking the type of condition, Decay or Defective restoration. The graphic view can be changed to select different areas on the tooth such as a Class V decay on the lingual view. However, the user can also use the checkboxes to quickly select the surface without needing to change the view.
Once all selections have been made, click OK to add this graphic to the chart and to add a line item to the clinical notes table.
Primary/Permanent and Unerupted
If a specific tooth needs to be changed, right click on the tooth and navigate to the Primary/Permanent node. Open the node by using the triangle to the left of the menu. Once open, select the type or the status of the tooth. Notice that the tooth will immediately update. A tooth that is marked as unerupted will be removed from the display and will use the URPT tag in place of the tooth number.
Note
The Note option in the Charting Options Menu creates a clinical note line in the Clinical Note Table, located at the bottom of the Restorative Charting window. A clinical Note can then be edited to enter any information related to the selected tooth.
Another way to create a clinical note is to click the plus at the right corner of the Clinical Note Table. This will create a new note associated to the selected tooth or teeth. If no teeth are selected, the clinical note will be created, but will not be associated to a specific tooth. To delete a Clinical Note, highlight the line item from the Clinical Note Table and press the delete key.
Toggle Watch
Teeth can be graphically notated to be watched closely by using the Toggle Watch in the Charting Menu. Simply select Toggle Watch and a red dot will be added onto the tooth in the chart. Click and drag the red dot to the surface that needs to be watched on the tooth.
When a watch is added to a tooth, a Clinical Note entry will be created in the Clinical Note Table. Additional information can be added to this note. If a tooth should not be marked as watch, simply select the entry from the Clincial Note Table and press the delete button. If a watch entry was added to a tooth but has now been corrected, right click on the clinical note and invalidate. This will remove the watch from the patient's chart but will leave the notes in the clinical table. A new watch can be added once the previous watch has been invalidated.
DR Images
The DR Images option in the Charting Options Menu will display the images associated to the tooth from within the Digital Radiography ability. Images must be tied correctly in the Digital Radiography ability. If images have been associated to the selected tooth in the Digital Radiography ability, tooth number color will be inverted like a radiograph.
The DR Images Window will show all of the images that are associated to the tooth number. Use the slider at the top of the screen to enlarge the images. If needed, double click the image to open the DR image editor.
DR Images can be seen in this menu, but can also be found in the DR Ribbon. Most often, the DR Ribbon is an easier workflow and will show more information then the Charting Menu.
Supernumerary
The Supernumerary option in the Charting Options Menu creates a graphical supernumerary tooth in addition to the regular tooth. Right click on the permanent tooth and select the Supernumerary option to create the extra tooth graphic.
A Supernumerary tooth will appear directly above the selected tooth on the patient's chart. This graphic can not be changed or moved like the other teeth in the MacPractice system. Supernumerary teeth will appear in Charting with a tooth image above each tooth number. The supernumerary tooth will be assigned the designated tooth number based on the Tooth Number Reference.
If a Supernumerary was accidentally added to a tooth, it can easily be deleted by selecting the code in the Clinical Note Table and pressing the delete key on the keyboard. View the Extraction section of the charting menu if the supernumerary needs to be extracted. To complete any other procedures on a supernumerary tooth, please go to the ledger to enter the charge.
