After we’ve processed your Stoma Appliance Scheme (SAS) claim you’ll get a Reconciliation statement.
The statement includes reason codes to help you correct claiming issues and explain the amount you’ve been paid.
There are 3 types of reason code:
- R – Reject
- W – Warning
- X – Time based warning, returning as a warning (W) for a set time period of 90 days. After this time the reason code will be returned as a Reject.
Use the filter box. Type in the reason code from the reason code message.
| Reason code | Reason type | Reason text |
|---|---|---|
| 029 | W | Form type was not provided or is invalid - should be ‘1’ original for ostomy. |
| 041 | R | The serial number was not provided or the serial number provided is invalid - provided as <>. |
| 042 | R | Duplicate serial number. |
| 050 | R | Date of supply provided is invalid. |
| 053 | R | The item code provided is invalid. |
| 055 | R | The brand provided is invalid - provided as <>. |
| 056 | R | The quantity was not provided or the quantity provided is invalid - provided as <>. |
| 092 | R | The date of supply of the ostomy item is after the revocation date for the Ostomy Association. |
| 093 | R | The date of supply of the ostomy item is after the suspension date for the Ostomy Association. |
| 094 | R | The date of supply of the ostomy item is prior to the approval start date for the Ostomy Association. |
| 100 | R | The date of supply of the ostomy item is after the approval end date for the Ostomy Association. |
| 101 | R | The item code provided is not an ostomy item. |
| 102 | R | Association type is not authorised to supply this item type. |
| 106 | R | The supplied quantity for this item exceeds the schedule maximum quantity. |
| 138 | W | Item on the item/brand translation table. |
| 141 | R | The item provided was not a benefit as at the date of supply. |
| 142 | W | The brand provided was not found on the stoma schedule at the date of supply. Brand will be ignored. |
| 144 | W | The supplied quantity for this item exceeds the schedule maximum quantity. |
| 158 | R | The supplied quantity for this item exceeds the maximum quantity amount authorised. |
| 205 | X | The Medicare number provided is invalid - provided as <>. |
| 206 | X | The DVA number provided contains invalid characters - provided as <>. |
| 207 | R | The passport number provided contains invalid characters - provided as <>. |
| 212 | R | The patient’s date of birth is an invalid date - provided as <>. |
| 213 | R | The Norfolk Island additional supply indicator should be Y or N. |
| 214 | R | The Norfolk Island additional supply amount is invalid. |
| 215 | R | The remote patient additional supply indicator should be Y or N. |
| 216 | R | The remote patient additional supply amount is invalid. |
| 217 | R | The remote patient additional supply end date is invalid. |
| 218 | R | The holiday additional supply indicator should be Y or N. |
| 219 | R | The holiday additional supply amount is invalid. |
| 220 | R | The holiday additional supply end date is invalid. |
| 221 | R | The clinical additional supply indicator should be Y or N. |
| 222 | R | The clinical additional supply amount is invalid. |
| 223 | R | The clinical additional supply Department of Health indicator should be Y or N. |
| 224 | R | The clinical additional supply end date is invalid. |
| 229 | W | Item identified as a possible duplicate based on Medicare number, item, supply date and quantity. |
| 230 | W | Item identified as a possible duplicate based on Medicare number, item and supply date. |
| 231 | R | The Norfolk Island additional supply indicator and data provided do not correspond. |
| 232 | R | The remotely located additional supply indicator and data provided do not correspond. |
| 233 | R | The holiday additional supply indicator and data provided do not correspond. |
| 234 | R | The clinical additional supply indicator and data provided do not correspond. |
| 235 | R | The clinical additional supply factor provided must be supported with approval from the Department of Health. |
| 240 | R | The date of supply is after the remotely located additional supply end date. |
| 241 | R | The number of months supplied for the Norfolk Island additional supply exceeds the maximum permitted. |
| 242 | R | The number of months supplied for the remotely located additional supply exceeds the maximum permitted. |
| 243 | R | The number of months supplied for the holiday additional supply exceeds the maximum permitted. |
| 247 | R | The date of supply and months requested in the holiday additional supply exceeds the approval end date. |
| 248 | X | The Medicare number provided is invalid. |
| 252 | X | The Medicare number provided is not current at date of supply. |
| 253 | X | The patient Medicare reference number provided in the claim was invalid. |
| 254 | X | Check patient reference and card issue numbers, names matched on the first 9 digits of Medicare number. |
| 255 | X | The Medicare number provided does not exist. |
| 256 | X | The Medicare number provided matched on surname only. |
| 257 | X | The Medicare number provided matched on first name only. |
| 258 | X | The Medicare number could not be matched with either the patient first name or surname provided. |
| 260 | X | The Medicare number provided has been reported stolen and has been cancelled. |
| 261 | X | The Medicare number provided has been reported lost and has been cancelled. |
| 262 | R | Medicare eligibility cannot be determined. |
| 263 | X | Medicare eligibility cannot be determined. |
| 264 | X | The DVA repatriation health card number provided is invalid. |
| 265 | X | The DVA repatriation health card number provided does not exist. |
| 267 | R | The patient’s Medicare number, DVA number or passport number was not provided. One of these identifiers are mandatory. |
| 268 | R | The Medicare number is valid, but no further checks applied as first name and surname not provided. |
| 269 | R | The Medicare number could not be confirmed, as first name and surname was not provided. |
| 298 | R | The date of supply provided is invalid - provided as <>. |
| 299 | R | A date of supply was not provided. |
| 597 | R | The date of supply is greater than 2 years old. |