Claim Screen - Item Details

Any fields not required for the particular claim being lodged will be greyed out.

This documentation is provided for informational purposes. In most instances the default settings will be correct except in the following circumstances:

1. Two services on the same day.
2. Speech Pathology DVA claims require a duration to be entered.

Field	Description
Item Number	The item being claimed for.
Date and time	Item Date is the date the service was rendered to the patient or the patient was assessed. Item Time is the time the service(s) was rendered.
Service Text	Service Text is a free text used to provide additional information to assist with the benefit assessment of the service.  DVA - Must have no more than 100 characters. VAA Medicare BulkBill - Must have no more than 500 characters.
Payment	Charge Amount is the amount charged for the service in cents. For Bulk Bill and DVA claims, this is the benefit assigned. Notional charge amounts are not acceptable for DVA medical pathology claims. Patient Contribution Amount is the amount paid by a patient to a provider for a service. It can be any amount paid by the patient where the service charge has not been fully paid.
Distance	Indicates travelling distance involved in a Home, Nursing Home or Hospital visit. If KM are to be claimed for a DVA claim, enter the total distance travelled here against the record with the Item Number = ‘KM’.
Duplicate Service Override	Duplicate Service Override indicates if practitioner attended patient on more than one occasion on same day. Each record MUST have the Time and the Duplicate Service Override checkbox ticked. NOTE  This is not an option for DVA Claims.
Duration	This captures the appointment length in minutes. It is required for ALL DVA Speech Pathology claims e.g. SH01 and MUST be entered manually or the claim will be rejected.

Other fields that may be required

Please note that a number of these fields will not be relevant in the Allied Health context.

SCP ID - Specimen Collection Point ID The Licensed Collection Centre Identifier, now known as Specimen Collection Point (SCPId), is used to identify the site where the pathology specimen was collected.

Restrictive Override - The indicator is used to allow payment for service where the account provides indication that the service is not restrictive with another service either within the same claim or on the patient history.

Options: SP: Separate Sites; NR: Not Related ( Care Plans ); NC: Not for Comparison.

After Care Override - Indicates if service is part of normal after care for the patient.

Multiple Procedure Override - Indicates whether service part of a multiple procedure or not. Note: when set, the associated claim is automatically set to pending.

Duration - The duration of the service in minutes required for DVA Speech pathology claims.

Equipment ID - The identification number of equipment used for the service provided (allocated by the Dept. of Health and Ageing).

Field Quantity - The number of fields irradiated or the quantity of time blocks for derived fee intrathecal or epidural infusion services (e.g. items 18219 and 18227) 2 characters max.

LSP - Location Specific Practice Number - only to be used in association with: services listed in the Diagnostic Imaging Services Table (DIST) Group T2 - Radiation Oncology services in the General Medical Services Table - (GMST) Where these services occur this field is to be considered mandatory. For details on the services that require an LSPN specified see LSPN Requirements

Number of Patients - The number of patients seen. Must be set for group attendance items (eg. counselling) or visits (home, hospital or institution) to ensure the correct payment is made.

Optical Script - Identifies the restriction override for optical claims.

Self Deemed Code - A Self Deemed service is a service provided by a consultant physician or specialist as an additional service to a valid request. A substituted service is a service provided that has replaced the original service requested.

Options: SD: Self Deemed; SS: Substituted Service; N: Not Self Deemed

Second Device Indicator - This field identifies the provision of a second medical grade footwear service.

Accession Date Time - This is a timestamp value as to when the pathology test was actually performed. Note: This is different to any DateOfService and TimeOfService.

Collection Date Time - This is the date time the actual pathology sample was taken extracted from the patient whether this be blood, tissue or a spontaneous ejection.

Dental - Jaw Identifies if the dental service relates to the upper or lower jaw. Note: The DVA Dental items that may require either a value of 'UPR' or 'LWR' to be present for claims processing purposes are as follows: D744,D743,S744 and S743

• Options: UPR: Upper Jaw; LWR: Lower Jaw
• Validation Rules: Must be one of 'UPR,LWR'. Must only be set when flags.serviceType is "G"
• Number of Teeth Max 2 characters.  Only applicable when Service Type is "G"
• Tooth  Identifies the tooth number that relates to the dental service provided. Note: The DVA Dental items that may require a Tooth number to be present for claims processing purposes are as follows: D311, D314, D322, D323, D324, D597, S311, S314, S322, S323, S324, S597 2 characters max.  Only applicable when Service Type is "G"