Due to our health center's large dental practice, the specific dental codes added for denominator inclusion (notably D7140, an extraction code) are most often used in emergent dental situations. With the addition of these codes, and the size of our health center's dental practice, the de facto expectation of this measure now is that dental providers would have BMI counseling conversations and document them during an encounter for a dental emergency or extraction.

The addition of these codes increased our denominator by 10%, exclusively patients who see only dental providers. 

Internal conversations around this change produce only confusion around the inclusion of emergent codes rather than comprehensive or periodic exams, if dental were to be included at all.

There is no mechanism for dental providers to have and document these conversations in the EDR, not to mention the clinical fact that an emergent dental encounter is not one where a BMI would be expected to be taken or addressed.

We request the removal of dental extraction and other emergent codes as inclusion in denominator criteria.