Have you had a patient in your chair for a 6-month checkup and, while you are perio charting, you notice that the wrong tooth is missing? After further investigation, you realize that the patient was in for an extraction three months ago, but the wrong tooth was set complete. You don’t know what to do, but the tooth chart needs to be fixed.

This happens more than you think. Sometimes the mistake is caught before month end is run and the procedures are locked up in history, so it can be fixed with just a change of the tooth number. But what do you do when the procedure has been posted, sent to the insurance company, paid, and put in history? Do you leave it? No, that is not the right answer. You must correct it and, if the patient has insurance, you should correct it with the insurance carrier as well.

The correct way to fix this situation after the procedure is to invalidate the procedure in history, post the correct procedure and tooth number, and then adjust the Ledger as necessary. There are two steps here . . . invalidating the procedure and the posting the adjustment.

When you invalidate a procedure, it only takes the procedure off the tooth chart. It does not change any charges in the Ledger. You can invalidate a procedure from the Patient Chart or from the Ledger.

After you have invalidated the procedure, you should repost it on the Ledger and make an adjustment to correct the patient balance. You will also need to fix the history with insurance as well, though this can be challenging. More than likely, you will need to send in clinical notes to prove the mistake or even send in X-rays.

In the end, having an accurate clinical record for your patient is the recommended option. Your patients’ clinical histories will follow them when they move or change practices, so it is best to keep their records as accurate as possible.

For additional information see the following blog posts: