Education guide - Medicare Online and ECLIPSE data elements
Explanations about common data elements or fields in Medicare Online and ECLIPSE that you might need to enter as part of a claim. Entering them correctly streamlines the claiming process.
Common data elements or field terms
This table explains common data elements or field terms and who can use them to make claims.
Different practice management software packages may have different data element or field names and locations to enter claiming data. Ask your software vendor or check your software help guide to find out more about how to enter data to lodge claims.
Health professional claim type where you should use the field or data element
|Data element or field||Description and usage||GP||Specialist||Radiology||Allied Health|
|Service text or Free text||
Only use this field when you need more information to support the claim for assessment. The field limit is 50 characters for Medicare claims. The limit for DVA claims is 100.
Check the table below for text field abbreviations. You can use the abbreviations if you’re running out of space.
Number of patients seen
This field indicates the number of patients a health professional has seen at a location. It includes patient visits to homes, hospitals, institutions or nursing homes. Use this for group attendance items, such as counselling.
You must supply this when you claim. If you don’t, you’ll get overpaid.
|Duplicate service override indicator||
This field indicates whether multiple services performed on the same day by the same health professional are separate services.
|Referral issue date||This is the date the referral was issued or written by the referring health professional. Use DDMMYYYY format.||No||Yes||Yes||Yes|
|Referral period type code||This code indicates the length of the referral period. The set values are:
|Referral override type code||
This code indicates why referral services were provided without a referral from another health professional.
The indicators or codes are:
Claim types for ECLIPSE in-patient medical claims (IMC) are:
|Request issue date||This is the date the requesting health professional wrote the request. Use DDMMYYYY format.||No||Yes||Yes||Yes|
Self-deemed codes indicate that a health professional has provided a service that would usually be a referred service without a referral or request.
There are 3 self-deemed codes:
Submit all self-deemed diagnostic imaging services without additional service text. If you need to add more text, begin the service text field with 'Self-deemed'.
Use this field for radiation oncology services - Medicare Benefits Schedule Group T2 services.
It’s used to provide the number of fields of treatment delivered to the treatment site or the quantity of time blocks for services.
If you don’t supply this information when claiming, you may get underpaid.
|SCPId||Use the Specimen Collection Point (SCPId) to identify the site where the pathology specimen was collected.||No||No||No||Yes|
If you need to provide more information about a service, use an abbreviation in place of the full description, where you can.
Ask your software vendor or check your software help guide to find out how to add more information to claims.
|HU2||Non-contiguous body areas|
|HU3||Contiguous body area with different setup required|
|HX1||Not for comparison|
|HX2||All x-rays specifically requested|
|HX4||Hand, wrist and forearm|
|HX5||Forearm and elbow|
|HX6||Elbow and humerus|
|HX7||Foot and ankle|
|HX8||Ankle and leg|
|HX9||Leg and knee|
|HXA||Knee and Femur|
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Page last updated: 10 September 2020
This information was printed 27 November 2020 from https://www.servicesaustralia.gov.au/organisations/health-professionals/topics/education-guide-medicare-online-and-eclipse-data-elements/32666. It may not include all of the relevant information on this topic. Please consider any relevant site notices at https://www.servicesaustralia.gov.au/individuals/site-notices when using this material.