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Document What is Regulation 11?

Regulation 11 is the treatment band that applies to replacement NHS dental appliances, when the original was lost or broken, due to an act or omission by a patient. This also applies to stolen appliances.

The only appliances that are covered by Regulation 11 are dentures, obturators, bridges and orthodontic appliances (for orthodontic contract holders only) The appliance must be a like-for-like replacement and both appliances must be provided by the NHS for Regulation 11 to apply.

A night guard / bite raising appliance is not covered by Regulation 11, a replacement night guard / bite raising appliance should be classed as a new Course of Treatment (CoT).

Regulation 11 doesn't apply to the two month continuation rule regardless of the time lapsed since the last CoT.
 



Patient charges and activity
 

  • The patient will pay 30% of the band 3 (per appliance) charge even if they do not normally pay (30% will always be rounded down to the nearest ten).
     
  • Claims for Reg 11 repair/replacement for a General item should be submitted on an FP17 which gives the providers the 12 UDAs but deducts the Patient Charge Revenue (PCR) from your Scheduled payments.
     
  • Claims for Reg 11 repair/replacement for an Orthodontic item should be submitted on an FP17(O) which does not deduct the PCR from your payments but also does not award any UOAs.
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