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Restriction codes

For some Medicare items or combinations of Medicare items that can be claimed, or duplicate items on the same day, you will need to supply additional or 'override' information with the item on the invoice. The Restriction Code on the Account Item window supplies additional information that will prevent a claim containing multiple similar items from being rejected.

Code

Restriction Code to select

Use when...

SP

Separate Sites

A service was performed at the same attendance (or same day) to different sites on the patient's body.

NC

Not for comparison

There was a separate clinical requirement for each item, and the service was not performed for reasons of comparison. Usually only applies to diagnostic and radiology services.

NR

Not related

A service was performed that is not associated with the patient's current care plan or cycle of care. For example, an unrelated service was performed at the same attendance as a care plan review.

For additional information and override codes, review the Department of Human Services online resource for Easyclaim terms.