Accommodation and Theatre Banding

There are four levels of accommodation and theatre banding, provided to the Centre by the individual health fund.

ACC1: Band 1, being minor surgical and non-surgical procedures normally not requiring any anaesthetic.

ACC2: Local anaesthetic.

ACC3: Band 3, carried out under general, regional anaesthesia or intravenous sedation. Theatre time < 1 hour.

ACC4: Band 4, as defined above. Theatre time > 1 hour.

ACC1A: Type C procedure (An individual contract may stipulate a different rate for type C procedures; and not all practices will use them)

Practices who qualify for the second > tier price structure are required to add the letter 'D' at the end of each item number (e.g. ACC1D, ACC2D, ACC3D). The 'D' triggers a change in the way the hospital claim form prints.

Rule 1: Day Surgery (DS) recognises codes with 'ACC' as accommodation based items

Rule 2: There is only one accommodation band per visit. If two or more theatre procedures are charged, then the accommodation code for the highest theatre band is used.

Rule 3: Case-based payment or episodic payments are bundled items. The amount charged includes costs for both procedure and accommodation and always end in with a 'C' (e.g. 42702C or 32093C). The 'C' identifies that it is case-based.