Service event—Medicare diagnostic imaging multiple services rule, code A

Identifying and definitional attributes
Metadata item type:	Data Element
Short name:	Medicare diagnostic imaging multiple services rule
METEOR identifier:	609643
Registration status:	Commonwealth Department of Health, Standard 14/10/2015
Definition:	The diagnostic imaging service rule that applies for a paid claim for the same patient, on the same date of service and by the same provider stem number, as represented by a code.

Value domain attributes

Representation class:

Code

Data type:

String

Format:

Maximum character length:

Permissible values:

Value	Meaning
A	Diagnostic imaging multiple service rule (DIMSR) A
B	DIMSR B HI
C	DIMSR B LO
D	DIMSR C
E	DIMSR B HI and DIMSR C
F	DIMSR B LO and DIMSR C
G	DIMSR B HI applied to consultation item
H	DIMSR applied to primary Multiple vascular ultrasound site rule (MVUSSR) item
M	DIMSR B HI adjusted to the consultation item
I	DIMSR B LO applied to consultation item
J	DIMSR applied to General Medical Services Table (GMST)
K	DIMSR manually applied
X	Exemption DIMSR
L	DIMSR manually applied DIMSR + MVUSSR

Guide for use:

CODE B Diagnostic imaging multiple service rule (DIMSR) B HI

Consultation greater than $40.

CODE C Diagnostic imaging multiple service rule (DIMSR) B LO

Consultation less than $40.

Guide for use:

Used in processing claims where multiple services are performed on a patient on the same date of service and by the same practitioner.

Submitting organisation:

Department of Health

Implementation in Data Set Specifications:

All attributes +

DSS specific attributes +
*Implementation start date:* 01/07/2013 *Implementation end date:* 30/06/2014 *DSS specific information:* Variable name = DIMSR