PBS Reason Codes
PBS reason codes can be loaded for use in your programs. These codes describe what has happened during the assessment of a PBS claim.
PBS reason codes are available as an Excel spreadsheet which is password protected. Pharmacy Dispensing Software vendors are supplied with the password.
Important: the PBS reason codes (CSV) [ZIP, 39KB] is updated monthly, as required.
If you require further clarification of these reason codes, please phone Medicare Australia on 132 290 (call charges may apply) and select option 2.
|Channel code||D||‘D’ – Default||Indicates which channel the fix instructions are designed for|
|B||‘B’ – B2B|
|Reason type code||R||‘R’ – Reject||Reject (Do not send paperwork for online claims)|
|X||‘X’- Time (warn then reject)||Time based Warning - Returned as a Warning (W) for a set period of time. After this time the reason code will be returned as a Reject (R).|
|Claimant Processing code||Numeric 00-99||00 - Default|
|02 - ISP down||Code supplied by pharmacy software to indicate a connection problem with Medicare Australia|
|Reason text||120 Characters||Reason code message|
|Fix instructions||3000 Characters||How to fix the problem|
|Contact details||300 Characters||Who to contact for info/help|
Last updated: 25 June, 2012