NEW ZEALAND HEALTH INFORMATION SERVICE
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Completing ADF96 Private Hospital Discharge Forms
Introduction
This guide will assist private hospitals and hospices to provide accurate discharge data to Clinical Coding Sector Services.
- It follows a step-by-step method.
- It includes all relevant information and instructions.
- It will be useful as a training tool.
- It will be useful as a reference guide.
ADF96 forms must be filled in for
- inpatients – patients who remain overnight are inpatients
- day patients – patients who attend for more than three hours and do not remain overnight are day patients
- any patient who dies while in hospital.
A form needs to be filled in after the patient is discharged, or transferred, or has died. Please do not send in ADF96 forms for residents in rest home beds.
Filling in the form
We cannot emphasise enough the importance of making sure that all writing is legible and in capital letters where appropriate.
Some sections of the ADF96 form must be filled in to provide Clinical Coding Sector Services with the minimum of useful information. These mandatory fields are marked in this guide.
The occupation of the patient needs to be reported for patients who have cancer. The full list of occupations and codes is included here.
Sending completed forms
Please send completed ADF96 forms to Clinical Coding Sector Services. ADF96 forms can be used by the hospital as part of the Register requirements and a photocopy sent to Clinical Coding Sector Services if desired. Batches of completed forms are to be sent monthly in order to ensure an even workflow and up-to-date information. A monthly batch will contain all forms for all discharges in the previous month.
We would prefer you to send the forms in batches of no more than 200 (for security reasons) and placed between two sheets of cardboard and tied. Please place forms covering MOH (previously HFA) and ACC contracted events on top and clearly label. This allows priority processing so that they are input into the NMDS within the timeframes required in your contracts. ADF96 forms can be sent in quarterly batches if a hospital generates fewer than 10 discharges per month on average. In all instances, all ADF96 forms for any calendar quarter (eg, January-February-March) must arrive within 28 days from the end of that quarter.
You can send completed forms to (and obtain new forms from):
Postal address:
Private Hospital
Clinical Coding
Sector Services
Ministry of Health
PO Box 5013
Wellington
Telephone: (04) 816 2883
Fax: (04) 816 2897
Other information
Assigning the patient the correct National Health Index (NHI) number requires accurate information on the patient’s personal details. This helps guarantee the integrity and accuracy of the data on the National Health Information Systems operated by Clinical Coding Sector Services.
Clinical Coding Sector Services is contracted to provide accurate procedure and discharge information to the Ministry of Health and the District Health Boards. This data is gathered from the ADF96 discharge forms, and so it is important that the procedural and clinical information provided to us is as accurate and complete as possible.
Some definitions
ADF96:
Private hospital discharge form first used in 1996. (An example is available as a PDF file (56 kB).)
Dates:
All dates on the ADF96 forms are to be filled in as DDMMYYYY.
DD refers to the day, MM to the month, and YYYY to the year.
Examples: the third of September 1962 is to be reported as 03091962; the fourteenth of October 1906 is to be reported as 14101906.
DHB:
District Health Board.
HAF:
Health agency facility. This is the healthcare facility (hospital or hospice) where the patient is treated. Each healthcare facility has been allocated a code number by Clinical Coding Sector Services.
HFA:
The Health Funding Authority, the principal government purchaser of healthcare services in New Zealand. The HFA merged with the Ministry of Health on 1 July 2000.
MOH:
Ministry of Health.
NHI:
The National Health Index is an alphanumeric index that uniquely identifies health care users across a number of national systems. It contains only information related to the identification of patients.
NHIS:
National Health Information Systems. These include the National Minimum Dataset (NMDS), the Medical Warnings System (MWS), and the National Health Index (NHI).
CCSS:
The Clinical Coding Sector Services, a group within the Ministry of Health.