A guide to using ACC in schools
- 1 February 2019
School Nurses routinely provide treatment for students with injuries such as grazes, cuts, strains and sprains, abrasions, and burns. Getting these addressed quickly in School Health Centres means local and free access to primary healthcare for students, less time out of school, and a reduced risk of infection. The resources needed to address these injuries can be costly for the school budget in nursing time and clinical resources. To help with these costs, Registered Nurses can lodge claims and invoice ACC for injury related treatment under the Cost of Treatment Regulations in the Accident Compensation Act. The ACC website is comprehensive and will assist you with information you need to enable this. Engagement and Performance Managers are a primary point of contact and provide you with support to help understand ACC’s legislation, policies and procedures. This link can help you access your local engagement and performance manager for support. Below we have summarised some of the things that School Nurses have questions about.
Registering as an ACC treatment provider
To invoice for treatment and lodge claims, you need to be registered as an ACC treatment provider. You can start this process by visiting the Health and Service Providers section of the ACC website. There you will find information on how to register as an ACC treatment provider, manage claims lodgement, and how much to invoice for treatment.
Lodging ACC claims
When registering a claim, you need to use a Read code that matches the diagnosis or type of injury. Read codes that nurses can use are located on ACC's website. You need to make sure that you use the code accurately, as any dot after the code is important.
Enrolled Nurses can also provide treatment to ACC clients however they:
- must be working under the direction and delegation of a Registered Nurse with an ACC treatment provider number
- must invoice under their supervising RN’s provider number.
Invoicing for Treatment
ACC does not expect Registered Nurses to invoice for anything that would normally be treated at home with basic first aid e.g. a small wound that requires a plaster or a small bandage. Typically, if the injury sustained would normally warrant a visit to the practice nurse, then this is something that ACC should be invoiced for.
Information on the amount you can currently claim for your nurses’ cost can be found on ACC's Cost of Treatment Regulations Information Sheet.
In this information sheet ACC state: For each visit ACC is liable to pay (current as of 18 January 2019) –
1. Either –
- i) $36.72, if the claimant is under 14 years old when the visit takes place; or
- ii) $17.25, if the claimant is 14 years old or over when the visit takes place;
2. the amount specified for any treatment the claimant receives.
|MB1||Treatment of burn less than 4cm2|
|MW1||Closure of open wounds less than 2cm2|
|MT1||Simple soft tissue injuries: management of simple sprain|
For subsequent visits/follow up treatment you are also able to claim the Nurse Consult (NCON) portion of the treatment provided, PLUS the treatment provided. For example, if the nurse undertakes a consult and then re-dresses a wound, it would be a consult + treatment (MW code).
Unless you have a separate financial arrangement from the school, funds should be deposited into a school account. It would be sensible to negotiate with the school how that will be administered. Ideally funds generated by the nurse will be applied to the nurse/clinic budget. This will enable the nurse to be accountable for budgets and the possibility of auditing by ACC. An agreement in writing with your school will ensure this becomes an ongoing arrangement.
Your clinical records need to show how you have reached your conclusions and why you provided specific treatment to your clients - notes should be full and accurate. They should be completed at the time of treatment or shortly afterwards. The quality of your notes may be important if a client is referred to other health providers, if ACC cover is being determined, or if ACC need to review your practice. Your clinical records must show that appropriate treatment has been provided for the services you invoice to ACC. Privacy is also very important, especially if your database is part of the school’s database - ACC expect to be notified if there are any potential privacy risks.