On 28 June 2024 we advised stakeholders about a small number of issues identified following making and publication of the Private Health Insurance (Medical Devices and Human Tissue Products) Rules (No. 1) 2024 (the Rules).
One of these issues is about the 6-digit format of new billing codes introduced in the July 2024 Prescribed List (compared with the existing 5-digit combination). Specifically, the concerns are that this new format is incompatible with stakeholders’ IT systems, preventing the Prescribed List from being successfully loaded.
The change in billing code format is required, as the alpha-numeric combinations used for the existing billing codes have been exhausted. The department advised about this change in billing code format during beta testing of the Health Products Portal (HPP), stakeholder meetings and webinars run in late 2023 and early 2024, with no issues raised at the time. The issue seems to have become evident when stakeholders attempted to load the July 2024 Prescribed List into their IT systems.
Additionally, the department has become aware about misunderstanding concerning the time frame for the implementation of this change.
In light of stakeholder feedback, we decided to urgently change the billing code format to 5-digits, by removing the second digit in the number, resulting in changing the new billing codes:
- from: 100001 […] 100312
- to: 10001 […] 10312
All alpha-numeric billing codes introduced previously remain unchanged.
The Prescribed List (Excel and XML) published on the department website on 29 June 2024 contains all billing codes in 5-digit format. We kindly ask all stakeholders to use these updates versions as the true reflection of the July 2024 Prescribed List.
As advised in PHI Circular 43/24, the department will be making an amendment to the Private Health Insurance (Medical Devices and Human Tissue Products) Rules (No. 1) 2024, expected around mid-to-late July 2024.