Handling two or more identical services on the same day with Not Duplicate Service flags

Medicare checks that electronic claims are not duplicates of other claims that have already been paid. This can cause issues where a patient requires more than one consultation on the same day, or is taken back to the operating theatre. To improve the likelihood of these claims getting paid, you can use the Not Duplicate Service (NDS) flag. This varies slightly depending on the claim type.

First enter the items as usual on the Invoice Items tab. For the majority of claims, the NDS flag is set on the Extra Details tab. You will need to enter the time of each service, the tick the NDS box on each affected item. This will automatically insert the appropriate service text on that item. When the claim is assessed by the Medicare operator they will be alerted by the NDS flag and service text and should accept both services. Note that the services can be on the same invoice or on seperate invoices however they will still need the start time and NDS flag set.

Extra Details tab with NDS

For Assistant Surgical claims, the procedure is slightly different. Because only the 513xx item is sent to Medicare, the Extra Details tab is unavailable. On Assist invoices you will see an NDS checkbox in the Procedure Details box, once a 513xx item has been calculated. You can set the time once you have ticked the check box. The details are automatically added to the Service Text. You should mark both of the invoices for the same patient/date of service with NDS and indicate the different times of service.

Assistant Surgical Claim with NDS

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