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Data Element Detail

Episode of care-compensable patient status
Identifying and Definitional Attributes
QH 042642 v3
Data Element
Derived Data Element
Draft
12-Jun-2014		Current
04-Aug-2014		Retired
30-Jun-2015
Standard
01-Jul-2014
30-Jun-2015
An episode of care for a patient who may be entitled to the payment of, or who has been paid compensation for, damages or other benefits (including payment in settlement of a claim for compensation, damages or other benefits) in respect of injury, illness or disease for which he/she is receiving care and treatment.
Hospital non-admitted patient care. Hospital outpatient clinic services excludes community mental health care (which includes hospital-based mental health ambulatory services).
Compensable patient status (ODC)
Representational Attributes
Numeric Character
Code
N(2)
2
2
Permissible Values

Permissible_values

CodeDescription
01Compensable - Workers' Compensation - Queensland
02Compensable - Workers' Compensation - Other
03Compensable - Third Party
04Compensable - Department of Veterans' Affairs
05Compensable - Motor Vehicle - Queensland
06Compensable - Motor Vehicle - Other
07Compensable - Department of Defence
97Non-compensable
98Compensable - Other
Supplementary Values

Supplemenary_values

CodeDescription
99Not stated/Unknown
Collection and Usage Attributes
Code 01 Compensable - Workers' Compensation - Queensland
The patient is entitled to claim damages under the Queensland Workers Compensation and Rehabilitation Act 2003. This includes workers injury claims managed by their employers' insurers, WorkCover Queensland and those Queensland firms who are self-insured. Q-Comp regulates these insurers.

Code 02 Compensable - Workers' Compensation - Other
The patient is entitled to claim damages under a Workers' Compensation Act other than Queensland, or other WorkCover insurance (e.g. if an employee of the Commonwealth or an Interstate Company or organisation not affiliated with Q-COMP).

Code 03 Compensable - Third Party
The patient is admitted to hospital for the treatment of an injury, illness or disease sustained in:
- A motor vehicle accident that occurred prior to 1 September 1994.
- An accident not associated with Compulsory Third Party (CTP) insurance and is not covered by worker's compensation insurance. For example, accidents involving: mobile machinery or equipment such as bulldozers and forklifts; or agricultural implements.
- A motor vehicle accident where liability is unclear, or where there is a possibility of shared liability.

This category may also be used for patients seeking to claim against public liability insurance, and who do not fit into any of the other categories.

Victims of criminal acts are not considered compensable so a charge is not to be raised for their treatment.

Code 04 Compensable - Department of Veterans' Affairs
The patient, an entitled veteran, whom the Department of Veterans' Affairs has accepted responsibility for the payment of any charges relating to his/her episode of care. This relates to all Gold Card holders and those White Card holders for specific illness or injury. White Card holders should not be classified as DVA patients unless they are receiving care or treatment for a condition recognised and accepted by DVA as a compensable condition.

Code 05 Compensable - Motor Vehicle - Queensland
The patient, admitted to hospital due to a motor vehicle accident, can establish negligence against an owner or driver of a Queensland registered motor vehicle.

Code 06 Compensable - Motor Vehicle - Other
The patient, admitted to hospital due a motor vehicle accident, can establish negligence against an owner or driver of a motor vehicle registered in a State or Territory other than Queensland.

Code 07 Compensable - Department of Defence
The patient, an Australian Defence Force staff member, whom the Department of Defence has accepted responsibility for the payment of any charges relating to his/her episode of care. This relates to permanent and part-time members. Part-time members should only be classified as Department of Defence where they seek and receive treatment for an injury or illness sustained while serving in the Defence Forces (e.g. Regular, Reserve Forces and Cadets).

Code 97 Non-compensable
The patient has no compensable entitlement.

Code 98 Compensable - Other
The patient has compensable entitlement other than stated above.

Code 99 Not stated/Unknown
The patient's compensable status is not stated or unknown.
Is mappable to the national data element, Patient-compensable status, as follows:
Code 01 Compensable - Workers' Compensation - Queensland is mapped to code 1 Compensable.
Code 02 Compensable - Workers' Compensation - Other is mapped to code 1 Compensable.
Code 03 Compensable - Third Party - Other is mapped to code 1 Compensable.
Code 04 Compensable - Department of Veterans' Affairs is mapped to code 2 Non-compensable.
Code 05 Compensable - Motor Vehicle - Queensland is mapped to code 1 Compensable.
Code 06 Compensable - Motor Vehicle - Other is mapped to code 1 Compensable.
Code 07 Compensable - Department of Defence is mapped to code 2 Non-compensable.
Code 97 Non-compensable is mapped to code 2 Non-compensable.
Code 98 Compensable - Other is mapped to code 1 Compensable.
Code 99 Not stated/Unknown is mapped to code 9 Not stated/not known.
This data element is necessary in the analysis of system utilisation and for funding purposes.
Relational Attributes
Related Metadata References

Related Metadata References_IR

  • 1 - 4
ViewRelationshipMetadata Item TypeMetadata Item SubtypeNameIdentifier & VersionApproval Status
SupersedesData ElementDerived Data ElementEpisode of care-compensable patient statusQH 042642 Version 2Superseded
Is derived fromData ElementData ElementEpisode of care-payment classQH 041742 Version 1Superseded
Relates toData ElementData ElementEpisode of care-expected principal source of patient fundingQH 040624 Version 4Superseded
Relates toData ElementData Element ConceptEpisode of careQH 041640 Version 1Current
Implementation in Metadata Sets

Implemented

No Metadata Items
Source and Reference Attributes
Compensable status;