PreMedicalCheck Dentist or oral surgeon? You want PreDentalCheck →

PreMedicalCheck — for physicians, oncologists, cardiologists, transplant & care coordinators

The Check

The documented dental clearance your patient needs before serious treatment starts. You already order it informally — "get your teeth checked before we begin" — but the step has no standard, no documentation format, and no name. So it gets done late, done vaguely, or not done, and your start date slips. The Check is that step, standardized: what to ask the dentist for, and what a real clearance looks like when it comes back.

The clinical question this page answers How do I get my patient's mouth cleared before we start treatment — and what do I actually need back from the dentist?

01 — The StandardSix scenarios where you should order the Check

Each scenario: why the clearance matters to your treatment plan, what to request from the dentist, and the reference behind it. This is the resource itself — no email required, nothing gated. Bookmark it.

Before chemotherapy or HSCT conditioning

Z51.11 · route via Z01.81 preprocedural exam

Why it matters to your plan
Neutropenic mucositis and odontogenic sepsis are documented, preventable complications. A dental source of infection found on day 6 of neutropenia is a treatment delay, an admission, or worse — found on day −14, it is a filling or an extraction.
What to request from the dentist
Exam with radiographs; stabilization of likely infection sources before conditioning; extractions timed to allow healing ahead of the neutropenic window; a dated clearance note back to you with any treatment dates. [1]

Solid-organ transplant, before listing

Z94.0–Z94.9 status · clearance precedes listing

Why it matters to your plan
Post-transplant immunosuppression converts an asymptomatic oral infection into a systemic one. Most programs make dental clearance a condition of listing — the failure mode is a patient who reaches the top of the list with it still undone.
What to request from the dentist
Full exam; diagnosis and treatment of active disease before listing; a dated clearance statement naming the planned transplant; explicit note of any deferred non-urgent treatment. Coverage exists; the clearance just has to be documented. [2]

Cardiac valve replacement or valvuloplasty

I05–I08 · I34–I36 · Z95.2 once valve is in

Why it matters to your plan
Oral bacteremia seeding a prosthetic valve is the mechanism behind prosthetic-valve endocarditis. Eliminating oral infection sources pre-operatively is the prevention step that is actually in your control.
What to request from the dentist
Resolution of active infection before the OR date; a clearance letter to the surgeon; an antibiotic-prophylaxis plan for the patient's future dental care per AHA guidelines. [2][3]

Before you prescribe high-dose antiresorptives

Denosumab · zoledronic acid · M81.x · oncology dosing

Why it matters to your plan
Medication-related osteonecrosis of the jaw risk rises sharply when extractions happen after high-dose antiresorptive therapy begins. The window to remove hopeless teeth is before the first dose — your prescription is the trigger for the Check.
What to request from the dentist
Extraction of non-restorable teeth completed, with healing confirmed, before the start date; risk counseling documented. Send the planned drug, dose, and start date with the referral — the dentist should not have to guess. [4]

Head and neck radiation, before simulation

C00–C14 · Z51.0 · field and dose decide the stakes

Why it matters to your plan
Radiation to the jaws permanently impairs healing; post-RT extraction in the field risks osteoradionecrosis, a problem with no good fix. Questionable teeth come out before RT, with healing time — which means the referral has to happen at simulation planning, not the week of treatment.
What to request from the dentist
Send the planned field and dose with the referral. Ask for: extractions completed with healing before RT start, fluoride carrier trays, and a follow-up protocol. Post-RT, note that a denture can be medically necessary for nutrition — say so in the chart. [1]

The clearance letter itself — what "cleared" must contain

One page · signed · dated · specific

Why it matters to your plan
"Seen, OK" is not a clearance — it will not survive a chart audit, a payer review, or a complication conference. The letter is the artifact your team actually needs, and you are allowed to specify it.
What to request from the dentist
Exam date; diagnoses with codes; treatment completed and treatment deferred (and why); an explicit statement — "no active oral infection" or the named exception; the planned procedure it clears; the dentist's direct contact. The Packet's templates do this for them. [5]

02 — The PacketThe coordination kit for your team

Everything above, turned into workflow tools. The Packet makes the clearance step happen on time with paperwork that comes back complete the first time — useful to your coordinators even if no one in your practice ever thinks about how the dental side bills it.

  • Scenario checklists (all six)One page each: when to order the Check, what to send with the referral, and what must come back before you proceed.
  • MD↔DDS coordination letter templatesThe request letter your coordinator sends ("here is the diagnosis, drug/field/date, here is what we need") and the clearance-response format the dentist returns. Fill-in, sign, fax or portal.
  • KX / ICD quick-reference coding sheetThe diagnosis codes and documentation attestations the dental side needs for each scenario — so their claim doesn't bounce and your patient doesn't get a surprise balance.
  • Referral formA single page your front desk completes in under two minutes and hands to the patient, so the clearance actually gets scheduled instead of recommended.

Free. Complete. Delivered as a single PDF kit. We will never call you about it, and there is nothing to upgrade to — this page sells nothing.

Get the Packet

Work email only. The full kit arrives as one PDF. No sales call, no demo, no subscription.

Used only to deliver the Packet and occasional updates to the Standard. Unsubscribe anytime.

Secondary — optional, print-and-hand-out

Give your patients this

Your team already sees these patients every day — the pre-transplant workup, the pre-chemo consult, the valve evaluation. That makes your clinic the distribution point. Print the one-pager or the QR card and hand it to the patient it applies to. It routes them to a free 2-minute qualifier that tells them whether their situation may qualify for medical coverage of the dental work — and, if they qualify, connects them to YesOnUs to pursue the claim. It costs you nothing and them nothing.

Download the patient one-pager + QR card (PDF)

One page, plain language, your patient keeps it. No login, no app — the qualifier is a link, not an install. Patient already has a denial in hand? Send them to CheckMyDenial.