2 posts / 0 new
Last post
sufianmehmood
Change diagnosis don't reflect in status query

Hi ACC support,

We are consuming change diagnosis API and sending below payload to compliance URL, We have got successful response from ACC but when we query the status from ACC it does not reflect the changed diagnosis, its shows only old diagnosis detail.

Below are the given details, Please review and advise, if we are doing any thing wrong.

ULR: https://provider.api-compliance.acc.co.nz/api/v2/claims/change-diagnosis

Request payload:
{
"pmsSoftwareName": "INDICI",
"pmsSoftwareVersion": "1.0.0",
"claimNumber": "TZ21927",
"declaration": {
"providerDeclaration": "2019-06-20"
},
"diagnosis": [
{
"diagnosisCodeType": "1",
"diagnosisCode": "283434009",
"diagnosisDescription": "Cut of knee",
"diagnosisSide": "left",
"diagnosisComment": "",
"diagnosisAction": "add",
"primaryDiagnosisIndicator": "True",
"diagnosisDate":"2019-02-02"
}
],
"patient": {
"address": {
"type": "Home",
"line1": "58B Elizabeth Street ",
"suburb": "Abbotsford",
"city": "Dunedin",
"postCode": "3330",
"country": "New Zealand"
},
"contact": {
"emailAddress": "missyjodyhabib@outlook.com",
"homePhone": "203210"
},
"details": {
"accidentDate": "2017-10-10",
"dateOfBirth": "2016-10-10",
"nhi": "VKS1466",
"firstName": "A",
"middleName": "A",
"surname": "Fmc"
}
},
"provider": {
"address": {
"type": "Home",
"line1": "107 Grandview Road",
"line2": "a b",
"suburb": "none",
"city": "Cable Bay Nelson District",
"postCode": "46000",
"country": "New Zealand"
},

"details": {
"providerId": "PPP101",
"providerTypeCode": "38",
"firstName": "Admin",
"middleName": "FMC",
"surname": "Fmc"
}
},
"vendor": {
"practiceName": "NorthCare Grandview Road",
"hpiOrganisationNumber": "ZZZ101",
"hpiFacilityNumber": "F2M067"
}
}

Change diagnosis API Response:
{
"medicalCertificateId": "111120197230000006429",
"medicalCertificate": {
"pmsSoftwareName": "INDICI",
"pmsSoftwareVersion": "1.0.0",
"claimId": "111120197230000006429",
"claimNumber": "TZ21927",
"provider": {
"details": {
"providerId": "PPP101",
"providerTypeCode": "38",
"firstName": "Admin",
"middleName": "FMC",
"surname": "Fmc"
},
"address": {
"line1": "107 Grandview Road",
"line2": "a b",
"suburb": "none",
"city": "Cable Bay Nelson District",
"postCode": "46000",
"country": "New Zealand",
"type": "Home"
},
"contact": null
},
"vendor": {
"practiceName": "NorthCare Grandview Road",
"hpiOrganisationNumber": "ZZZ101",
"hpiFacilityNumber": "F2M067"
},
"patient": {
"address": {
"line1": "58B Elizabeth Street",
"line2": null,
"suburb": "Abbotsford",
"city": "Dunedin",
"postCode": "3330",
"country": "New Zealand",
"type": "Home"
},
"contact": {
"homePhone": "203210",
"workPhone": null,
"mobilePhone": null,
"emailAddress": "missyjodyhabib@outlook.com"
},
"details": {
"nhi": "VKS1466",
"firstName": "A",
"middleName": "A",
"surname": "Fmc",
"dateOfBirth": "2016-10-10",
"accidentDate": "2017-10-10"
}
},
"diagnosis": [
{
"diagnosisCodeType": "1",
"diagnosisCode": "SD6y2",
"snomedCode": "283434009",
"snomedCodeDescription": "Cut of knee",
"diagnosisDate": "2019-02-02",
"diagnosisComment": "",
"primaryDiagnosisIndicator": "True",
"diagnosisDescription": "**Superficial injury of knee NOS",
"diagnosisAction": "add",
"diagnosisSide": "left"
}
],
"workCapacity": null,
"declaration": {
"providerDeclaration": "2019-06-20"
}
},
"createdAt": "2019-07-23",
"lastUpdate": "2019-07-23"
}

Status Query URL: https://provider.api-compliance.acc.co.nz/api/v2/claims/status?claimNumber=TZ21927&vendorId=ZZZ101&providerId=PPP101

Status Query Response:
{
"message": "Success",
"generatedAt": "2019-07-24",
"pageSize": 25,
"totalPages": 1,
"page": 1,
"claimStatusList": [
{
"acc45Number": "TZ21927",
"claimNumber": "TZ21927",
"coverStatus": "Held",
"injuryResolved": null,
"injuryResolvedFromDate": null,
"injuryResolvedToDate": null,
"partialNHINumber": "TVY1",
"accidentDate": "2019-07-23",
"diagnoses": [
{
"diagnosisCodeType": null,
"diagnosisCode": "SH502",
"diagnosisDescription": "Unspecified thickness burn of the foot",
"snomedCode": "11980003",
"snomedCodeDescription": "Burn of foot (disorder)",
"injuryStatus": "Provisional",
"resultErrorCode": "EM00",
"resultError": null,
"diagnosisAction": null,
"diagnosisSide": "left"
}
]
}
]
}

Thanks
Sufian


kaaran@ACC
Change of Diagnosis is a request and not an immediate change

Hi Sufian,

Let me clarify the details for this particular API. The Change of Diagnosis API is a request to change the diagnosis on a claim which is then processed by an ACC case manager. This is not an immediate change to the claim details in our claim database (which is what your claim query can see).

To process these change of diagnosis it can take up to 20 business days for this to process through by a case manager and be applied to the claim on the database. Once this is processes, then the status for your query will update as expected, but if this request is reviewed and rejected by an internal process then the status will not update. ACC will notify the clinician directly about this.

With compliance testing, these requests are passed through to the test queues, but there aren’t any case managers processing these requests so unfortunately the query will not update. The important thing for you to see is that the payload has been successfully received by ACC in the compliance environment.

 

If you have any other questions, please let me know.

 

Kind Regards

Kaaran@ACC 


Add new comment