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AC1 - Maximum reached

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Background:

You have reached the maximum number of times you can bill this code within a time period.  For example, consults/(re) assessments have limits on the number of times you can bill in a 12-month period – refer to the Schedule of Benefits, section GP12 for more details.

Solution:

Consider billing a lower paying code (e.g., if originally billed a Consultation, then resubmit with a Medical Specific Assessment).  Alternatively, if the patient is seen for a second time with a clearly defined unrelated diagnosis, then consider billing the same service code again, but with the different diagnosis code.  Refer to the Schedule of Benefits section GP12 for more details.

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