New Zealand Gazette – 2001 – No. 44

Page 994

✨ Pharmaceutical Claims Transaction Categories



994 NEW ZEALAND GAZETTE No. 44

23

Transaction Category

  • Indicates if the claim is a standard claim, Credit Transaction, non-claim item or a resubmission of a previous claim.

  • The appropriate codes are:

    Transaction Category Code
    Standard claim I or Null
    Credit transaction C
    Non claim transactions N
    Resubmission R
    Owed balance O

Standard Claim

  • First time submitted claim lines need to be submitted with a [Transaction Category] = “T” for Invoice.

Credit Transactions

  • Credit line transactions are used to credit a previously submitted claim transaction.

  • These may either be used independently, to credit a previous transaction claimed, or as part of a resubmission.

  • Credit line transactions need only contain the following data elements in the Transaction Record of a claim file:

    Field No Name Notes
    10 Record Type Refer field 1.
    21 Sequence No Refer field 2.
    22 Unique transaction number Must be the same [Unique Transaction Number] of the transaction to be credited.
    If Credit as part of a resubmission, [Unique Transaction Number] must be number of
    Historical record (refer [Unique Transaction Number] for further explanation).
    23 Transaction Category = “C”
    62 Prescription ID Must be the same [Prescription ID] of the transaction to be credited.
    63 Prescription ID suffix Must be the same [Prescription ID Suffix] of the transaction to be credited.


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Online Sources for this page:

VUW Te Waharoa — PDF NZ Gazette 2001, No 44


Gazette.govt.nz — PDF NZ Gazette 2001, No 44




✨ LLM interpretation of page content

🏥 Transaction Record Detail (continued from previous page)

🏥 Health & Social Welfare
27 April 2001
Pharmaceutical Claims, Transaction Records, Data Fields, Audit, Resubmission