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Pharmaceutical Benefits Scheme (PBS) prescription—PBS claim type, code A

Identifying and definitional attributes

Metadata item type:Help on this termData Element
Short name:Help on this termPBS claim type
Synonymous names:Help on this termClaim level
METeOR identifier:Help on this term603902
Registration status:Help on this termCommonwealth Department of Health, Standard 17/12/2015
Definition:Help on this termThe type of benefit claim made under the Pharmaceutical Benefits Scheme (PBS) for the prescription medicinal product, as represented by a code.
Data Element Concept:Pharmaceutical Benefits Scheme (PBS) prescription—PBS claim type

Value domain attributes

Representational attributes

Representation class:Help on this termCode
Data type:Help on this termString
Format:Help on this termA
Maximum character length:Help on this term1
Permissible values:Help on this term
ValueMeaning
CStandard Pharmaceutical Benefits Scheme (PBS) co-payment claim
UUnder co-payment claim

Collection and usage attributes

Guide for use:Help on this term

CODE U   Under co-payment claim

This code is used to describe instances where the dispensed price of the prescribed medicinal product is less than the amount of the applicable co-payment.

Source and reference attributes

Submitting organisation:Help on this termDepartment of Health

Data element attributes

Collection and usage attributes

Guide for use:Help on this term

Care should be taken when interpreting this data element. The 'Under co-payment claim' category (Code U) is known to include some claims where the patient co-payment is less than the dispensed price due to the patient being eligible for Closing the Gap co-payment relief, i.e. the category includes a number of claims classified as under co-payment claims as a result of application of the Closing the Gap entitlement provisions.

Users are advised to exclude prescriptions for Closing the Gap co-payment eligible patients when attempting to ascertain the true number of under co-payment claims.

Source and reference attributes

Submitting organisation:Help on this termDepartment of Health

Relational attributes

Related metadata references:Help on this term

See also Patient—Closing the Gap co-payment eligibility indicator, code AAA[NNA] Commonwealth Department of Health, Standard 17/12/2015

Implementation in Data Set Specifications:Help on this term

Pharmaceutical Benefits Scheme (PBS) state/territory data extract 2013-14 Commonwealth Department of Health, Standard 17/12/2015

DSS specific attributes +
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