Billing Service Elements

Billing Service Elements

Service Elements are set at the time of billing.
These service elements all have conditions that apply to their use and these should be used only where required.

Billing Comments
Medicare online only allows 50 characters in billing comments. DVA Allow 100 Characters.
Where possible use the least number of characters in description eg: Low L leg [lower Left leg]
Where hospital Billing is done ensure that hospital name [Description] in Setup\ Locations is also reduced 
e.g.: RPA is 3 characters [Royal Prince Alfred Hospital is 28 characters] 
This narrowed description enables you to add any other relevant comment regarding the  item billed without it being cut off at the character limit.

Billing Service Elements
Located at the bottom of the billing grid
All billing service elements must be set at time of billing for electronic transmission. Impulse has always complied with these rules.
On the billing screen and where appropriate, a comment is required, this must be set in the comments field. 

Restrictive Override
3 New restrictive override codes have been released by Medicare to cater for items where restrictions apply.
Restrictive Override Code 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.
  1. SP = Separate Sites 
  2. NR = Not Related (Care Plans) 
  3. NC = Not for Comparison
Substituted Service
SS: A substituted service is a service provided that has replaced the original service requested.
SD: A Self Deemed service is a service provided by a consultant physician or specialist as an additional service to a valid request. [ Referral override code]

Not Duplicate Service 
Practitioner attended patient on more than one occasion on same day. Service text must be included

Not Normal After Care 
Indicates if service is part of normal aftercare for the patient

Multiple procedure override
Indicates whether service part of a multiple procedure or not.
Note: when set, the associated claim is automatically sent to Medicare pend for assessment manually. Service text must be included to provide details regarding the multiple procedure.

Rule 3 Exempt
Indicator used to indicate Rule 3 in the Medicare Benefits Schedule (MBS), applies to the pathology service and Indicates patients that had multiple pathology tests within a 24 hour period due to a chronic illness, resulting in a higher rebate.

S4B3 Exempt
Flags the associated service as requiring assessing, in accordance with S4B3 requirements, of the MBS schedule.

2nd Device
This field identifies the provision of a second medical grade footwear service. Allied Health Service indicator

Time Dependant Override
Indicates if the service is to have time dependant item restrictions applied

Equip ID
The identification number of equipment used for the service provided (allocated by the Dept. of Health and Ageing). LSPN Number required. 
Associated with magnetic radiation and radiation oncology.

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

Time Duration
The duration of the service in minutes  Eg 015,030 etc. Set In Allied Health Speech Pathology as an example.

KM
DVA Claims only
 Indicates travelling distance involved in a Home, Nursing Home or Hospital visit. Must be greater than a value of 10, must be set when ItemNum is set to KM

Accession Date\ Time
This is a timestamp value as to when the pathology test was actually performed. Please be aware of all pathology rules for this service
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. Please be aware of all pathology rules for this service.












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