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National Health Amendment Regulations 2002 (No. 1)

Authoritative Version
  • - F2002B00263
  • No longer in force
SR 2002 No. 262 Regulations as made
These Regulations amend the National Health Regulations 1954.
Administered by: Health
General Comments: This instrument was backcaptured in accordance with Section 36 of the Legislative Instruments Act 2003
Registered 01 Jan 2005
Tabling HistoryDate
Tabled HR11-Nov-2002
Tabled Senate12-Nov-2002
Gazetted 06 Nov 2002
Date of repeal 19 Mar 2014
Repealed by Health (Spent and Redundant Instruments) Repeal Regulation 2014

National Health Amendment Regulations 2002 (No. 1)1

Statutory Rules 2002 No. 2622

I, PETER JOHN HOLLINGWORTH, Governor-General of the Commonwealth of Australia, acting with the advice of the Federal Executive Council, make the following Regulations under the National Health Act 1953.

Dated 30 October 2002

PETER HOLLINGWORTH

Governor-General

By His Excellency’s Command

KAY PATTERSON


1              Name of Regulations

                These Regulations are the National Health Amendment Regulations 2002 (No. 1).

2              Commencement

                These Regulations commence on gazettal.

3              Amendment of National Health Regulations 1954

                Schedule 1 amends the National Health Regulations 1954.


Schedule 1        Amendments

(regulation 3)

  

[1]           Paragraph 49B (1) (g)

substitute

               (g)    Australian Refined Diagnosis Related Groups Definitions Manual Version 4.1;

               (h)    Australian Refined Diagnosis Related Groups Definitions Manual Version 4.2;

                (i)    Australian Refined Diagnosis Related Groups Definitions Manual Version 5.0.

[2]           Schedule 7, Part 1, item 2, definition of NHDD

substitute

NHDD means version 10 of the National Health Data Dictionary, published in 2001.

[3]           Schedule 7, Part 1, after item 4

insert

    4A.       If a hospital episode includes the supply of a prosthesis, the prosthetic record supplied to the Department by a fund for the episode must comply with Part 7 (File structure and record content: prosthetic record).

    4B.       If a patient is treated in a hospital under an AN-SNAP funding agreement between the hospital and a fund, the AN-SNAP record supplied to the Department by the fund for the hospital episode must comply with Part 8 (File structure and record content: AN-SNAP record).

[4]           Schedule 7, Part 2, item 3, column 2

substitute

CMBS item/Miscellaneous service code/ADA code

[5]           Schedule 7, Part 2, item 6, column 2

substitute

Fund medical benefit

[6]           Schedule 7, Part 2, item 9

substitute

9

Gap cover scheme identifier

66

5

1

10

Total record length

70

 

 

[7]           Schedule 7, Part 3, item 15, column 2

substitute

Total prostheses charge

[8]           Schedule 7, Part 3, item 16, column 2

substitute

Total prostheses benefit

[9]           Schedule 7, Part 3, item 27, column 2

substitute

Total item charges

[10]         Schedule 7, Part 3, item 39, column 2

substitute

Infant weight, neonate, stillborn

[11]         Schedule 7, Part 3, items 44 to 68

substitute

44

Care type

219

3

1

45

Total leave days

222

4

1

46

Non-certified days of stay

226

4

1

47

Principal diagnosis

230

5

1

48

Additional diagnosis

235

5

19

49

Procedure

330

7

20

50

Same-day status

470

1

1

51

Principal CMBS item number/Miscellaneous service/ADA code

471

14

1

52

Principal CMBS item date

485

8

1

53

Minutes of operating theatre time

493

4

1

54

Secondary CMBS item number/Miscellaneous service code/ADA code

497

14

9

55

Days of hospital in the home care

623

2

1

56

Total psychiatric care days

625

3

1

57

Mental health legal status

628

1

1

58

ICU hours

629

4

1

59

Urgency of admission

633

1

1

60

Inter-hospital contracted patient

634

1

1

61

Palliative care status

635

1

1

62

Unplanned readmission within 28 days

636

1

1

63

Unplanned theatre visit during episode

637

1

1

64

Marital status

638

1

1

65

Provider (hospital) code of facility from which patient transferred

639

8

1

66

Provider (hospital) code of facility to which patient transferred

647

8

1

67

Discharge intention on admission

655

1

1

68

Gap cover scheme identifier

656

5

1

69

Total record length

660

 

 

[12]         Schedule 7, Part 4, item 3, column 2

substitute

CMBS item/Miscellaneous service code/ADA code

[13]         Schedule 7, Part 4, item 6, column 2

substitute

Fund medical benefit

[14]         Schedule 7, Part 4, after item 8

insert

9

Gap cover scheme identifier

A(5)

MAA

Approved gap scheme identifier in the format <Fund ID><two digit code>

Blank indicates no gap cover scheme applied for this medical service

[15]         Schedule 7, Part 5, item 2, column 5

after

(Part 4)

insert

, the prosthetic record (Part 7) and the AN-SNAP record (Part 8)

[16]         Schedule 7, Part 5, item 3, column 5

substitute

The hospital provider number

OVERSEAS = overseas provider

[17]         Schedule 7, Part 5, item 5, column 5

after

N = a hospital with which the fund does not have a contract

insert

T = a hospital that is paid under 2nd Tier benefit arrangement

B = a hospital that is paid under a ‘Bulk payment’ arrangement

[18]         Schedule 7, Part 5, items 15 and 16

substitute

15

Total prostheses charge

N(5)

MAA

The total amount (rounded to the nearest dollar) that a hospital has charged for all prostheses used as part of an episode of care

0 = no prosthesis charge billed

 

 

 

 

Blanks only valid if a prosthesis charge was not separately identified but billed under another charge item

16

Total prostheses benefit

N(5)

MAA

The total amount (rounded to the nearest dollar) that a health fund has paid as a benefit for all prostheses used as part of an episode of care

0 = no prosthesis charge paid

 

 

 

 

Blanks only valid if a prosthesis charge was not separately identified but paid under another charge item

[19]         Schedule 7, Part 5, item 23, column 5

omit

Blank = there is a FED but the amount is unknown

[20]         Schedule 7, Part 5, item 25, column 5

substitute

The ancillary charges incurred during the episode and billed against an ancillary table

0 = no ancillary charges incurred during the episode

[21]         Schedule 7, Part 5, item 26, column 5

substitute

The ancillary benefits paid for charges billed as occurring during the episode

0 = no ancillary benefits paid during the episode

[22]         Schedule 7, Part 5, item 27

substitute

27

Total item charges

N(6)

MAA

The total amount (rounded to the nearest dollar) of all item charges shown in Part 4 associated with the episode of care

[23]         Schedule 7, Part 5, item 30, column 5

substitute

The patient’s residential postcode

9999 = unknown postcode

[24]         Schedule 7, Part 5, item 31, column 5

omit

0 = unknown

insert

3 = indeterminate

9 = not stated/inadequately described

[25]         Schedule 7, Part 5, item 36, column 5

substitute

The DRG code which best classifies the episode of care using an Australian National or Refined Diagnosis Related Group classification

Blank filled if not known

[26]         Schedule 7, Part 5, item 37, column 5

after

41 = version 4.1

insert

42 = version 4.2

50 = version 5.0

[27]         Schedule 7, Part 5, item 39

substitute

39

Infant weight, neonate, stillborn

N(4)

MAA

The first weight (in grams) of the live born or stillborn baby obtained after birth, or the weight of the neonate or infant (if aged less than 365 days and weighing less than or equal to 9 000g) on the date admitted if this is different from the date of birth

0 = not applicable

[28]         Schedule 7, Part 5, item 40, column 5

substitute

The number of hours, rounded to the nearest hour, that the patient received mechanical ventilation during the episode

0 = no mechanical ventilation

[29]         Schedule 7, Part 5, item 41, column 5

substitute

1 = discharge or transfer to an acute hospital

2 = discharge or transfer to a residential aged care service, unless this is usual place of residence

3 = discharge or transfer to a psychiatric hospital

4 = discharge or transfer to another health facility

5 = statistical discharge or type change

6 = left against medical advice or discharge at own risk

7 = statistical discharge from leave

8 = died

9 = other (includes discharge to home or usual pace of residence)

[30]         Schedule 7, Part 5, item 44

substitute

44

Care type

N(3)

MAA

10 = acute care

20 = rehabilitation care

21 = rehabilitation care delivered in a designated unit

22 = rehabilitation care according to a designated program

 

 

 

 

23 = rehabilitation care is the principal clinical intent

30 = palliative care

 

 

 

 

31 = palliative care delivered in a designated unit

 

 

 

 

32 = palliative care according to a designated program

 

 

 

 

33 = palliative care is the principal clinical intent

 

 

 

 

40 = geriatric evaluation and management

50 = psychogeriatric care

 

 

 

 

60 = maintenance care

70 = newborn care

80 = other admitted patient care

 

 

 

 

90 = organ procurement — posthumous

100 = hospital boarder

[31]         Schedule 7, Part 5, item 46

substitute

46

Non-certified days of stay

N(4)

MAA

The number of days spent in the hospital, without certification, that exceeded 35 days

0 = no non-certified days

[32]         Schedule 7, Part 5, item 47, column 2

omit

code

[33]         Schedule 7, Part 5, item 49, column 2

omit

codes

[34]         Schedule 7, Part 5, item 51, column 2

substitute

Principal CMBS item number/Miscellaneous service code/ADA code

[35]         Schedule 7, Part 5, item 52, column 2

substitute

Principal CMBS item date

[36]         Schedule 7, Part 5, item 53

substitute

53

Minutes of operating theatre time

N(4)

MAA (sameday patients only)

Total time (in minutes) spent by a patient in operating theatres during current episode of hospitalisation

[37]         Schedule 7, Part 5, item 54, column 2

substitute

Secondary CMBS item numbers/Miscellaneous service codes/ADA codes

[38]         Schedule 7, Part 5, item 55

substitute

55

Days of hospital in the home care

N(2)

MAA (Hospital-in-home episodes only)

The number of hospital in the home days occurring within the episode of care for the patient

0 = not applicable

[39]         Schedule 7, Part 5, item 57, column 5

after

2 = voluntary patient

insert

3 = not permitted to be reported under legislative arrangements in the jurisdiction

8 = not applicable

[40]         Schedule 7, Part 5, items 59 and 60

substitute

59

Urgency of admission

N(1)

OPA

1 = urgency status assigned — emergency

2 = urgency status assigned — elective

3 = urgency status not assigned

9 = not known/not reported

60

Inter-hospital contracted patient

N(1)

OPA

1 = inter-hospital contracted patient from public sector

2 = inter-hospital contracted patient from private sector

3 = other

9 = not reported

[41]         Schedule 7, Part 5, item 65, column 2

substitute

Provider (hospital) code of facility from which transferred

[42]         Schedule 7, Part 5, item 66, column 2

substitute

Provider (hospital) code of facility to which transferred

[43]         Schedule 7, Part 5, item 67, column 5

omit

6 = usual residence

insert

8 = died

9 = usual residence/other

[44]         Schedule 7, Part 5, item 68, column 5

substitute

Approved gap scheme identifier in the format <Fund ID><two digit code>

Blank = no part of the episode was covered by a gap cover scheme

[45]         Schedule 7, Part 6

substitute

Part 6          Registered health benefits organisations

 

Item

Name

Identifier

1

A.C.A. Health Benefits Fund

ACA

2

A.M.A. Health Fund Limited

AMA

3

Australian Health Management Group Limited

AHM

4

Australian Unity Health Limited

AUF

5

AXA Australia Health Insurance Pty Ltd

AXA

6

CBHS Friendly Society Limited

CBH

7

Cessnock District Health Benefits Fund Limited

CDH

8

Credicare Health Fund Limited

CPS

9

Defence Health Limited

AHB

10

Federation Health

YMH

11

GMHBA Limited

GMH

12

Goldfields Medical Fund (Inc)

GMF

13

Grand United Corporate Health Limited

FAI

14

Grand United Health Fund Pty Ltd

GUF

15

HBF Health Funds Inc

HBF

16

Health Care Insurance Ltd

HCI

17

Healthguard Health Benefits Fund Limited

HHB

18

Health Insurance Fund of WA

HIF

19

Health-Partners Inc

SPS

20

Hospital Benefits Association Limited

HBA

21

Hospital Contribution Fund of Australia Limited, The

HCF

22

I.O.R. Australia Pty Ltd

IOR

23

IOOF Health Services Ltd

IOF

24

Latrobe Health Services Inc

LHS

25

Lysaght Peoplecare

LHM

26

Manchester Unity Australia Ltd

MUI

27

Medibank Private Limited

MBP

28

Medical Benefits Fund of Australia Ltd

MBF

29

Mildura District Hospital Fund Limited

MDH

30

Mutual Community Ltd

MCL

31

N.I.B. Health Funds Limited

NIB

32

National Mutual Health Insurance

NMH

33

Naval Health Benefits Society

NHB

34

NRMA Health Pty Ltd

SGI

35

Phoenix Health Fund Limited

PWA

36

Queensland Country Health Limited

MIM

37

Railway and Transport Employees’ Friendly Society Health Fund Ltd

RTE

38

Reserve Bank Health Society Ltd

RBH

39

South Australian Police Employees’ Health Fund Inc

SPE

40

St Luke’s Medical and Hospital Benefits Association Limited

SLM

41

Teachers Federation Health Ltd

NTF

42

Transition Benefits Fund Pty Ltd

TBF

43

Transport Friendly Society Ltd

TFS

44

United Ancient Order of Druids Friendly Society Limited

UAD

45

United Ancient Order of Druids Registered Friendly Society Grand Lodge of New South Wales

UAF

46

Western District Health Fund Ltd

WDH

Part 7          File structure and record content: prosthetic record

 

Item

Data item

Start Position

Field size

Required

Coding description

1

Fund identifier

1

A(3)

MAA

See fund codes

2

Link identifier

4

A(24)

MAA

A unique identifier of an episode that links Data items from this Part (Part 7) to the medical record (Part 4) and the hospital episode record (Part 5).  The fund may encrypt the membership identifier for this purpose

3

Prosthetic item

28

A(5)

MAA

Billing code in the format AA999 as specified in the database of prosthetic items maintained by the Department

4

Number of prosthetic items

33

N(3)

MAA

Number of prosthetic items identified in item 3 used

5

Prosthetic item charge

36

N(5)

MAA

Total charge for prosthetic items identified in item 3 (including the supply charge where relevant)

6

Prosthetic item benefit

41

N(5)

MAA

Total benefit for prosthetic items identified in item 3  (including the supply benefit where relevant)

Part 8         File structure and record content: AN‑SNAP record

 

Item

Data item

Start position

Field size

Coding description

1

Fund identifier

1

A(3)

See fund codes

2

Link identifier

4

A(24)

A unique identifier of an episode that links Data items from this Part (Part 8) to the medical record (Part 4) and the hospital episode record (Part 5). The fund may encrypt the membership identifier for this purpose

3

Episode type

28

A(1)

O = overnight admitted patient

S = sameday admitted patient

4

Admission FIM Item Scores

29

N(1) (17 Repeats)

The FIM score on admission for each of the 18 FIM motor and cognition items.  Each item has a maximum score of 7 and a minimum score of 1. Total scores can range from 18 to 126. Admission data must be collected within 72 hours after admission. Guide for Uniform Data Set for Medical Rehabilitation procedures for scoring the FIM should be followed.  FIM scores are as follows:

 

 

 

 

No helper:
7 = complete independence
6 = modified independence

 

 

 

 

Helper:
5 = supervision or set up
4 = minimal assistance
3 = moderate assistance
2 = maximal assistance
1 = total assistance

Blank entries not valid for these fields

5

Discharge FIM Item Scores

47

N(1) (17 Repeats)

The FIM score on discharge for each of the 18 FIM motor and cognition items.  Each item has a maximum score of 7 and a minimum score of 1. Total scores can range from 18 to 126. Discharge data must be collected within 72 hours prior to discharge. Guide for Uniform Data Set for Medical Rehabilitation procedures for scoring the FIM should be followed.  FIM scores are as follows:

 

 

 

 

No helper:
7 = complete independence
6 = modified independence

 

 

 

 

Helper:
5 = supervision or set up
4 = minimal assistance
3 = moderate assistance
2 = maximal assistance
1 = total assistance

Blank entries not valid for these fields

6

Functional Impairment Codes

65

A(7)

The Impairment Code (Version 5.0 UDS excluding ‘Medically Complex’) that best describes the primary reason for admission to the episode. To be coded as specifically as possible, avoiding the use of impairment group 13 (‘Other Disabling Impairments’) where possible.  Entry should consist of:

 

 

 

 

     ·  2 digits representing impairment group

     ·  a decimal point

     ·  up to 4 digits that represent more specific categories within impairment groups

7

Assessment Only

72

N(1)

AN-SNAP has separate classes for Assessment Only episodes. Assessment Only occurs when the patient was seen once only for assessment or treatment and no further intervention by this service team is planned to occur within the next 90 days. If a patient is booked or seen for subsequent treatment within 90 days, the episode is not Assessment Only. If a patient is booked for subsequent assessment (but not treatment), the episode is Assessment Only.  Record:
1 = Yes
2 = No

8

AN-SNAP Class

73

N(3)

The AN-SNAP class to which the episode is assigned. This can be derived from items in this Part together with patient ‘age’ (from date of birth).  May be blank filled if not known

Notes

1.       These Regulations amend Statutory Rules 1954 No. 35, as amended by 1957 No. 71; 1958 No. 63; 1962 Nos. 55, 70 and 113; 1965 Nos. 17, 94 and 185; 1966 No. 99; 1967 No. 86; 1969 Nos. 91 and 220; 1970 Nos. 70 and 166; 1971 Nos. 28, 76, 103 and 138; 1972 No. 79; 1973 Nos. 17, 75, 111, 221, 225 and 267; 1974 Nos. 52, 104, 105, 113 and 263; 1975 Nos. 14, 49, 66, 100, 124, 165 and 207; 1976 Nos. 113, 217 and 227; 1977 Nos. 11, 34, 51 and 112; 1978 Nos. 66, 178, 208 and 266; 1979 Nos. 59, 107, 208 and 231; 1980 Nos. 84, 292 and 309; 1981 Nos. 43, 97, 115, 232 and 318; 1982 Nos. 38, 82, 84, 250 and 284; 1983 Nos. 45, 247 and 267; 1984 Nos. 66, 161, 200, 308, 322 and 427; 1985 Nos. 86, 136, 186, 187, 206 and 288; 1986 Nos. 47, 53, 208, 330, 353 and 360; 1987 Nos. 50, 76, 100 and 310; 1989 Nos. 291, 292 and 334; 1990 Nos. 24, 86, 114, 292, 335 and 396; 1991 Nos. 40, 41, 232, 262, 263, 310 and 339; 1992 Nos. 136 and 187; 1993 Nos. 48, 85, 153, 260, 261, 273, 280 and 284; 1994 Nos. 2, 9, 106, 139, 201, 253, 256, 296, 349 and 451; 1995 Nos. 1, 14, 34, 52, 109, 116, 161, 220, 288, 289, 408 and 410; 1996 Nos. 46, 183 and 333; 1997 Nos. 16, 58, 133, 160, 179 and 353; 1998 Nos. 18, 73 and 262; 1999 Nos. 18, 140, 162, 174, 175, 236, 288 and 289; 2000 Nos. 2, 218, 242 and 315; 2001 Nos. 14, 67, 123 and 282.

2.       Notified in the Commonwealth of Australia Gazette on 6 November 2002.