Medicare Patient History (NHSI) Mainframe 011-21100735

Table 1

Table 2

Note: when a function key is used the label changes to BASIC. When used a second time NHSI shows the original header details.

To access function keys [PF13] to [PF24] use the shift key plus the function key that corresponds to your selection. For example, [PF14] becomes [Shift] and [PF2].

Table 3

Note: more details can be viewed by placing the curser:

• under the header or value in the column and pressing PF1, and/or
• on Indicators, codes, modifiers and control lines for claims processing in Medicare

  Header	Description	PF1
  PATIENT	The patient’s abbreviate first name shows in this column.	Patient name as shown on the Medicare card Gender Date of birth PIN Card Issue CSN and FTB elibility
  ITEM	The item number or service code shows in this column.	Item description as written in QITI at the DOS claimed. Explanation of Alpha value Example: AH or SR.
  FST DT	The date of service (DOS) or referral/request date is shown.	If Item is CLID the Minor Customer ID name shows.
  LSDT	The date a referral expires shown as MMYY. Note: indefinite referrals show as 1259.
  NO	The number in this column indicates: the number of patients seen for bulk consultation items the number of lines below relating to a PAYP line the number of lines above that a referral or request relates to the number of additional fields for a radiation oncology service
  PROVIDER	The provider number of the servicing, referring, requesting or PAYP appear in this column. ACRF details also appear in this column.	Paygroup ID and start date Mainframe search reference Provider Name Practice address Speciality codes
  P	The payee code shows in this column.	Information of payee code used.
  CHARGE	The amount charged or assigned for bulk bill shows in this column. Note: notional charges show as a blank value and the total shows on the first item in the service group.	For patient claims the Claimants details show.
  BENEFIT	The system calculated benefit shows in this column. Note: notional charges show as a blank value and the total shows on the first item in the service group.	For patient claim EMSN eligibility and benefit show.
  PI	Any processing indicators (PI) used show in this column. Note: the system only shows one PI regardless if multiple are used on a claim.	Information of PI used.
  RSN	Any reason (RSN) code used shows in this column. Note: the system only shows one RSN regardless if multiple are used on a claim.	Information of the RSN used.
  TX	Any claim or service text shows in this column.	T: Shows claims text. X: Shows Adjustment details.
  PRC DT	The date of processing (DOP) for the service line.
  OPER	The P number of the operator who processed the service line. Note: Mainframe shows an operators P number Universal Logins are not used in mainframe.
  CLM ID	The claim ID for bulk bill or simplified billing/ECLIPSE claims appear in this column.
  INDX	The position number of a bulk bill claim, or patient claims relative position shows in this column.
  MD	Any fee modifiers used show in this column.	Information of the modifier used.
  FEE	The schedule fee used by the system in determining the benefit for a service.
  DOL	The date of lodgement (DOL) for the service line.
  POSN	The position number of a bulk bill claim, or patient claims relative position show in this column.
  CT	The claim type shows in this column.	Information on the claims type.
  SORC	The source office code of the operator who processed the service line shows in this column.	Information on the Source office code.
  N	This column indicates grouping of items processed as a notional charge.
  MO	This column shows what multiple operation rule applies to a service line.	Information on the Multiple Operation Rule applied to the item.
  DIMS	This column shows what diagnostic imaging multiple service rule applies to a service line.	Information on the Diagnostic Imaging Multiple Service Rule applied to the item.
  VU	This column shows what multiple vascular ultrasound service site rule to a service line.	Information on the Multiple Vascular Ultrasound Services Site Rule applied to the item.
  MMRI	This column shows what multiple musculoskeletal MRI service rule applies to a service line.	Information on the Multiple Musculoskeletal MRI Services Rule applied to the item.
  ME	This column shows what multiple echocardiogram service rule applies to a service line.	Information on the Multiple Echocardiogram Services Rule applied to the item.
  AST	This column indicates who an assistant surgeon item has been paid to.	Information on assistant payment method.
  HOSP GAP$	The gap amount for an in hospital service shows in this column.
  SUB$	The amount substantiated for a service line shows in this column. Note: PF6 shows EMSN amounts and PF18 shows MSN amounts.
  UNSUB$	The amount unsubstantiated for a service line shows in this column.
  PIN	The patients PIN shows in this column.
  TIME	The time of processing the service line shows in this column. The time is Canberra time.
  CHQ/EFT	The Reserve Bank cheque number, or patients EFT details show in this column.	Information on bank account and claimant details for an EFT payment.
  ISS DT	The issue date of a cheque or EFT payment shows in this column.
  STAT	The status of a cheque or EFT payment shows in this column.	Information on a Cheque’s status.
  S	The state code of a system generated cheque shows in this column.	Information on the State code for a cheque.
  QUALFR	Any item qualifiers (IE Equipment number) show in this column.
  LSPN	This column shows the LSPN for a diagnostic imaging item in this column.

Table 4: this table contains a list of common values seen in Medicare patient claim history ITEM field that are not MBS items.