NHS orthodontic claims (FP17O)

Contents

    Referral dates, IOTN, the FP17DCO plan, and FP17O assessment, treatment start and completion claims, including commissioning approval, PAR scores, repairs and Regulation 11.

    Who it is for: practice managers and administrators, clinicians, receptionists.

    In this guide:

    1. Understand the stages of an NHS orthodontic claim
    2. Book a referred orthodontic patient and record the IOTN
    3. Give the patient an FP17DCO orthodontic treatment plan
    4. Claim an orthodontic assessment or treatment start
    5. Check and correct Part 5 of an FP17O
    6. Claim the end of orthodontic treatment
    7. Claim an orthodontic repair or Regulation 11 replacement

    1. Understand the stages of an NHS orthodontic claim

    You can name the FP17O claim stages and which outcome to use at each one.

    Why this matters NHS orthodontic contracts are paid in Units of Orthodontic Activity (UOAs). Unlike a general course, an orthodontic case is usually claimed twice: once at the start and once at the end. Using the wrong outcome either loses UOAs or claims ones you haven’t earned.

    The two parts of the FP17O

    • Part 5: Orthodontic Assessment and Treatment Start, sent at the start:
      – Assess & Review: you assessed the patient and will see them again, for example because they are too young to start.
      – Assess & refuse treatment: treatment isn’t needed or isn’t eligible (for example, IOTN too low), or the patient declines.
      – Assess & appliance fitted: the patient accepted treatment and the appliance has been fitted. This claim carries the main UOAs for the case.
    • Part 6: Orthodontic Completion, sent at the end, with the outcome Treatment completed, Treatment discontinued, Treatment Abandoned – patient failed to return or Treatment Abandoned – patient requested. PAR scores are recorded here.

    How ChiralCloud shows them In NHS Management and the claims history, the Form column shows the stage, for example:

    • FP17O (Assess and Review), FP17O (Assess and Refuse)
    • FP17O (Form 1 waiting for fit): accepted, but the appliance isn’t fitted yet
    • FP17O (Form 1 fitted)
    • FP17O (Form2, Treatment complete) and the other Form 2 outcomes

    Good to know

    • Assessments earn a small number of UOAs. The fitted claim earns the bulk, and ChiralCloud estimates it from the patient’s age. Completion claims carry no further units.
    • Send each claim within two months of the event (the fit or the last visit). Late claims may not count.

    2. Book a referred orthodontic patient and record the IOTN

    You can record the referral date and the patient’s IOTN so they reach the FP17O.

    Why this matters Most NHS orthodontic patients are referred by their general dentist. The FP17O needs the date of referral, and NHSBSA checks that it comes before the assessment and acceptance dates. The Index of Orthodontic Treatment Need (IOTN) decides whether a patient under 18 qualifies for NHS treatment. Usually they need a Dental Health Component (DHC) of 4 or 5, or a DHC of 3 with an Aesthetic Component (AC) of 6 or more.

    Where to find it

    • When booking: the NHS panel in the add-appointment dialog.
    • IOTN: the patient’s Ortho tab, IOTN panel.

    How to

    1. When you book the first orthodontic appointment, tick Treatment On Referral in the NHS panel header.
    2. Enter the Referral Date from the referral letter. It is the date the referral was made, not the date you received it.
    3. Book as usual. The referral date is saved with the course and copied onto the FP17O.
    4. At the assessment, the clinician enters DHC and AC in the IOTN panel on the patient’s Ortho tab.
    5. Save the record.

    Good to know

    • The IOTN entered here becomes the IOTN and aesthetic component on the claim. Edit Claim shows the IOTN label in red if it is 0. Fix it before you submit.
    • Patients aged 18 or over need commissioning approval from the commissioner before NHS orthodontic treatment. ChiralCloud flags their claims with an exclamation mark (see the next steps).
    • A missing referral date is a common reason for rejection. Check it on every new referral.

    More detail: Patient orthodontic assessment.

    3. Give the patient an FP17DCO orthodontic treatment plan

    You can produce an FP17DCO from the appointment editor.

    Why this matters Before NHS orthodontic treatment starts, the patient (or their parent) must be given a written treatment plan. In England this is the FP17DCO. It sets out what you propose, the appliances and retainers, the estimated time, any charge, and who is providing it. The patient signs it to accept. It is also good evidence of informed consent: it shows you explained the options, the risks and the commitment needed.

    Where to find it In the appointment editor for an NHS patient, the NHS FP17(DC0) button on the toolbar. It only appears for NHS patients.

    How to

    1. Click NHS FP17(DC0). The NHS FP17(DC0) dialog opens.
    2. Under The following Treatment is Proposed, choose Upper, Lower, Both or None for prominence, Alignment of teeth, bite problems (Anterior/Posterior) and Closure of spacing. Tick impacted teeth, permanent teeth to be removed and Other objectives as needed.
    3. Under Treatment appliances (“braces”) to be used, set Removable and Fixed, tick Headgear or Other appliances, and enter Estimated treatment time (months).
    4. Under Retention appliances (“retainers”) to be used, set Removable and Fixed, and choose Estimated time Up to 12 months, Long-term or Permanent.
    5. Choose the Charge Band under Dental Charges.
    6. Under Declarations, tick I am the patient or I am the Patients Parent / Guardian.
    7. Choose the Performer and add any Additional Information.
    8. Click OK. ChiralCloud saves a Standard FP17(DCO) document to the patient’s record to print or send.

    Good to know

    • Most NHS orthodontic patients are under 18 and don’t pay. For a paying adult, make sure the charge band is right.
    • The form follows the NHSBSA FP17DCO layout last revised in 2021. If NHSBSA publishes a new version, check with Chiral Systems.

    4. Claim an orthodontic assessment or treatment start

    You can chart the right outcome so Commit Appointment stacks the correct FP17O.

    Why this matters ChiralCloud decides which FP17O to make from the orthodontic outcome code you chart at the appointment. If no outcome code is charted, nothing is claimed. If the wrong code is charted, the wrong form is sent.

    Where to find it An appointment whose type is set up as orthodontic, in the appointment editor.

    How to

    1. At the assessment, chart the treatment code your practice uses for the outcome. Each is linked to an NHS code:
      – Assess and Review
      – Assess and Refuse treatment
      – Assess and Appliance TO BE FITTED: accepted, but the appliance will be fitted at a later visit
      – Assess and Appliance fitted: accepted and fitted today
    2. Chart any appliances fitted, such as Fixed Upper Appliance, Fixed Lower Appliance or Functional Appliance.
    3. Click Commit Appointment and complete the receipt. The claim is stacked.
    4. Check it on the Stacked tab in NHS Management. Its Form shows the stage.

    Good to know

    • ChiralCloud fills in the assessment, acceptance and fitting dates from this appointment. If any of them was a different day (for example, the patient accepted after the assessment), correct it in Edit Claim › Orthodontic Assessment and Treatment Start (part 5).
    • A Form 1 waiting for fit claim stays on Stacked. Submit Claims doesn’t send it until it shows as fitted.
    • If the patient is 18 or over and was referred after 1 April 2019, an exclamation mark appears on the stacked claim. You must hold commissioning approval and tick it in Part 5 before you submit.

    5. Check and correct Part 5 of an FP17O

    You can correct the outcome, dates, IOTN, declarations and commissioning approval on a Part 5 claim.

    Why this matters Most FP17O rejections come from Part 5. The usual causes are a referral date after the assessment, a missing IOTN, or a missing declaration. Checking Part 5 before you submit saves weeks of resubmissions.

    Where to find it NHS Management, right-click the claim, Edit Claim, then the Orthodontic Assessment and Treatment Start (part 5) tab. You need the UDA claims permission.

    How to

    1. Under Part 5, check the outcome: Assess & Review, Assess & refuse treatment or Assess & appliance fitted.
    2. Check the dates:
      – Date of Referral: from the referral letter.
      – Date of Assessment.
      – Date of Acceptance: click Copy Assessment Date if the patient accepted on the same day.
      – Date Appliance Fitted: Copy Assessment Date copies the assessment date here too.
    3. Set IOTN (0–5; the label turns red at 0) and Aesthetic Component (0–10).
    4. Tick the right declaration: “All the necessary care and treatment that the patient is willing to undergo will be provided” when treatment is starting, or “…has been carried out” for an assessment only.
    5. For patients 18 or over, tick Commissioning Approval once you hold it.
    6. Check the Provider, and add Observations (pick from Insert template if you like) and Comments.
    7. Click OK to save the stacked claim.

    Good to know

    • The dates show Unavailable if the course has no referral date. Add the referral date to the booking first.
    • The IOTN must be 1 to 5 for the claim to be accepted. 0 means it wasn’t recorded.

    6. Claim the end of orthodontic treatment

    You can stack and check a Part 6 completion claim, including PAR scores.

    Why this matters Every case that started on the NHS must be closed with a Part 6 completion claim. That is true whether it was finished, stopped by you, or abandoned by the patient. NHSBSA uses completion claims and PAR scores to monitor outcomes. Commissioners also look at how many cases each contract completes.

    How to

    1. At the debond or final visit, chart the completion code: Treatment Completed, Treatment Discontinued, Treatment Abandoned – patient FTR or Treatment Abandoned – patient requested.
    2. If a patient has stopped attending, chart Treatment Abandoned – patient FTR at an admin appointment, using the date of their last visit.
    3. Commit Appointment. A Form 2 claim is stacked with no units.
    4. In NHS Management, right-click it, choose Edit Claim, then the Orthodontic Completion (Part 6) tab.
    5. Check the outcome under Part 6. The choices are the four above, plus Repair to applicance fitted by another dentist and Regulation 11 replacement appliance (see the next step).
    6. Check the Performer.
    7. If you measured PAR, tick Par Score Calculated and enter the Pre-Treatment Par Score and Post-Treatment Par Score (0–99).
    8. Enter the IOTN and Aesthetic Component at the end of treatment.
    9. Check the Date of Completion or last visit, then click OK.

    Good to know

    • NHSBSA asks contracts for samples of PAR scores. Record them for every completed case you score.
    • IOTN not Applicable appears on the tab, but at present ticking it doesn’t change the claim.

    7. Claim an orthodontic repair or Regulation 11 replacement

    You can claim a repair to another dentist’s appliance or a Regulation 11 replacement appliance.

    Why this matters Two orthodontic situations sit outside the usual start and completion claims. One is a repair to an appliance fitted by another dentist, for example a patient who moved area part-way through treatment. The other is a Regulation 11 replacement appliance, when a patient has lost or broken an appliance through their own fault and must pay a charge for the replacement.

    How to

    1. Chart Repair to Appliance fitted by another dentist, or Regulation 11 Orthodontic with the appliance being replaced.
    2. Click Commit Appointment. For Regulation 11, ChiralCloud takes the replacement charge even if the patient is normally exempt, because this charge applies to everyone.
    3. Check the claim on the Stacked tab. Its Form shows (Repair to applicance fitted by another dentist) or (Regulation 11 replacement appliance).
    4. Submit as usual.

    Good to know

    • Explain the Regulation 11 charge to the patient (or parent) before you make the new appliance. It surprises people who are used to free treatment.
    • NHSBSA changed how stand-alone orthodontic repairs are claimed from April 2026: they now go in as a “charge exempt” claim. ChiralCloud’s handling was still being updated at the time of writing, so check with Chiral Systems before you submit repair claims.
    • Check the amount for a Regulation 11 replacement of more than one appliance against current NHSBSA guidance before you issue the receipt.
    Updated on 4th November 2026

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