NEW ZEALAND HEALTH INFORMATION SERVICE
Home > technical documentation > guide to ADF96 form
Completing ADF96 Private Hospital Discharge Forms
Event information
Event type (mandatory field)
A two-digit code from the list below, identifying the type of health event.
__________________________________________________________
BT Birth event (infants born in reporting hospital)
IP Non-psychiatric inpatient event (include day patients)
ID Intended day case
__________________________________________________________
Health agency facility name (HAF) (mandatory field)
Report the name of the hospital where the patient is being treated.
Use the empty space beside the ‘Event information’ heading if necessary.
HAF code (mandatory field)
The four-digit code unique to your hospital.
Please contact the Private Hospital Section, NZHIS, if this code is not known.
Admission date (mandatory field)
The date the patient was admitted to your hospital.
This is sometimes known as the ‘Event Start Date’.
Discharge date (mandatory field)
The date the patient was discharged or transferred from your hospital, or the date the patient died whilst still in care.
This is sometimes known as the ‘Event End Date’.
Admission source (mandatory field)
A single-digit code from the list below describing whether the patient’s admission was routine or a transfer from another hospital.
_________________________________
R Routine
T Transfer from another hospital
_________________________________
Admission type (mandatory field)
A two-digit code from the list below describing the admission type.
AA, AC and AP are the most common.
This is sometimes known as the ‘Event Start Type’.
____________________________________________________________________________________________
AA Arranged admission
(A planned admission where:
– the admission date is less than seven days after the date the decision was made by the
specialist that this admission was necessary, or
– the admission relates to normal obstetric cases, 37 to 42 weeks gestation, delivered
during the event.)
AC Acute admission
(An unplanned admission on the day of presenting at the admitting healthcare facility.
Admission may have been from the Emergency or Outpatient Departments of the healthcare
facility.)
AP Elective admission to a private hospital
WN Waiting list/Booking list
(A planned admission where the admission date is seven days or more after the date the
decision was made by the specialist that this admission was necessary.)
____________________________________________________________________________________________
Discharge type (mandatory field)
A two-digit code from the list below describing the type of discharge from your hospital. DD, DR, and DT are the most common.
This is sometimes known as the ‘Event End Type’.
____________________________________________________________________________
DR Ended routinely
DT Discharge of patient to another healthcare facility (transferred)
DD Died
DI Self-discharge from hospital (indemnity signed)
DS Self-discharge from hospital (no indemnity)
DA Discharge to acute specialist facility (neonates and burns only)
DW Patient discharged to another specialty service within the same facility
____________________________________________________________________________
Principal purchaser (mandatory field)
A two-digit code from the list below identifying the organisation or body which purchased the healthcare service provided. The purchaser who paid the most should be selected in cases that have more than one purchaser, unless the MOH (previously HFA) or DHB have been involved in funding (subsidy, top-up, partial, or full). In this case use code 13 in the ‘Principal purchaser’ field.
____________________________________________________________
06 Privately funded NZ citizens
13 DHB/MOH base purchase
98 Other / not specified
A0 ACC – direct purchasing
A1 FIS – direct purchase, Fusion Insurance Services
A2 NZI – direct purchase, NZ Insurance Ltd
A3 HIH – direct purchase, HIH WorkAble Ltd
A4 MMI – direct purchase, MMI General Insurance (NZ) Ltd
A5 FMG – direct purchase, Farmers’ Mutual Accident Care Ltd
A6 AWK – direct purchase, At Work Insurance Ltd
A7 CIG – direct purchase, Cigna Insurance Ltd
____________________________________________________________
Health agency (mandatory field)
Report the organisation that holds the contract for treating this patient. (The hospital that physically provides the healthcare is reported in the Health Agency Facility field.)
There are four common scenarios:
- Your hospital has a contract with ACC or an accident insurer to treat the patient. Report your own Health Agency code and choose the correct Principal Purchaser code to show the organisation paying for the treatment.
- The patient is paying for their own care or it is being paid for by a private health insurer (eg, Southern Cross). Report your own Health Agency code and choose the ‘06’ Principal Purchaser code to show that healthcare is being privately funded.
- Your hospital has a contract with a DHB or MOH (previously HFA) to treat this patient. Report your Agency code and choose Principal Purchaser code 13 to show that the event is publicly funded.
- Your hospital has a contract with a public hospital for treating this patient, ie, your hospital holds a sub-contract of a MOH (previously HFA) contract. Report the public hospital’s Health Agency code and choose the principal purchaser code 13 to show the event is publicly funded.
For example: Capital and Coast hospital have a contract with the Ministry of Health to treat patients on a booking list. They subcontract some of their booking-list patients to be treated at a private hospital. The contract between Capital and Coast and the private hospital states that the private hospital will report these events to NZHIS. The event is coded with Capital and Coast as the Health Agency (ie, the hospital with the original contract), and the private hospital as the Health Agency Facility (ie, the private hospital that did the work). The purchaser code is 13, to indicate that this is a publicly funded event.
See the Health Agency code table. Alternatively, please contact NZHIS if you require the Health Agency codes.
Specialty code (provide using the Health Specialty code table)
A three-digit code from the list in the appendix to this guide. Choose the code that best reflects the specialty or service to which a patient has been assigned.
Weight on admission (mandatory field for infants aged less than 29 days on admission)
The weight, in grams, of any infant patient.
- Infants are those who are under 29 days of age. Acceptable values are between 0001 and 9999 grams.
The earliest of the following dates that led to this hospitalisation:
- the date of the doctor’s referral letter
- the date the patient presented for self-referral
- the date of transfer from another facility.
The date of the first specialist consultation that led to this event. This includes consultation with a specialist in private practice. (The format is DDMMYYYY).
- This may be the same as the Referral date, for example in the case of an emergency admission.
The date on which the patient was assessed as requiring surgery. (The format is DDMMYYYY).
Also known as ‘Booking List Date’.
Surgical priority (provide if known)
A single-digit code from list below describing the severity of the patient’s condition at the date surgery was confirmed.
______________
R Routine
S Semi-urgent
U Urgent
______________
Days on leave (provide if applicable)
The number of days an inpatient is absent from the hospital. A day is counted at midnight. This includes ‘holiday’ leave and time spent in another hospital.
- A discharge is considered to be effective on the date of the patient leaving hospital if they have not returned after three days (ie, more than three midnights). A readmission (with a new ADF96 form to be completed) is considered to occur if the patient returns after three days.
- There is no limit to the total number of leave days or periods a patient can be absent for, provided that no single period is longer than three days (as above). Total accumulated leave days should be noted on the form.
Enter ‘N’ (no) if a patient requests that details of a hospitalisation be passed to the event summary of the Medical Warnings System (ie, do not suppress).
Enter ‘Y’ (yes) if no such request is made.
The four fields – Referral date, First consultation date, Waiting list date, and Surgical priority – need to be completed only for specific publicly funded procedures. These are total hip replacement, total knee replacement, and coronary artery bypass graft.