All treatment provided on behalf of ACC must be necessary, appropriate and clinically justified. The prior approval (ACC32) process ensures claims are treated in line with this by requiring providers to obtain approval before starting additional treatment. Here is important information about the ACC32 process for you to be aware of.
Using Treatment Profiles
Treatment Profiles are guides to the treatment and rehabilitation services ACC expects a practitioner to provide to a client for a particular injury. They describe current ‘good practice’ and what outcomes should be achieved.
Complete versions of the treatment profile guides can be downloaded using these links:
- ACC1032 Chiropractic Treatment Profiles 2003 (PDF 808K)
- ACC2361 Acupuncture Treatment Profiles May 2006 (PDF 1.2M)
Treatment trigger numbers
Treatment trigger numbers indicate the number of treatments a client with a particular injury is able to receive before the provider is required to seek prior approval.
In cases where no treatment trigger number is associated with a Read code, providers can give up to a maximum of six treatments per claim, and if further treatments are required prior approval must be sought before providing any additional treatment.
If you consider that further treatments are required, then you will need to complete an ACC32 form before providing any additional treatment.
Because treatment profiles do not currently exist for osteopathy, an interim set of trigger numbers is being adopted based on physiotherapy profiles. ACC will work with the osteopathic associations to develop a long-term solution.
For more information on:
- the ACC32 form, please refer to the Treatment Provider Handbook
- Read codes, see our Read code section.
Communicating the process to providers
Back in November 2010 we sent letters to all acupuncturists, chiropractors and osteopaths registered with ACC informing them of changes that were introduced on 1 December 2010. Copies of these letters can be downloaded using the links below:
- Acupuncture ACC32 process change letter (PDF 28K)
- Chiropractic ACC32 process change letter (PDF 29K)
- Osteopathic ACC32 process change letter (PDF 29K)
Answers to frequently asked questions on the Treatment Profile trigger change
For more guidance see these Frequently asked questions on the Treatment Profile trigger change (PDF 67K).
Download lists of triggers numbers
The following are full lists of the currently approved treatment trigger numbers in various formats. These documents are updated from time to time. Please ensure you take a quick look at the Guide to using trigger numbers (PDF 15K) and that you use the most up to date list:
Acupuncture treatment trigger numbers
- Acupuncture treatment trigger numbers (XLS 122K)
- Acupuncture treatment trigger numbers (CSV 12K)
- Acupuncture treatment trigger numbers (TXT 12K)
- Acupuncture treatment trigger numbers (PDF 24K)
Chiropractic treatment trigger numbers
- Chiropractic treatment trigger numbers (XLS 55K)
- Chiropractic treatment trigger numbers (CSV 4K)
- Chiropractic treatment trigger numbers (TXT 4K)
- Chiropractic treatment trigger numbers (PDF 9K)
Osteopathic treatment trigger numbers
- Osteopathic treatment trigger numbers (XLS 137K)
- Osteopathic treatment trigger numbers (CSV 14K)
- Osteopathic treatment trigger numbers (TXT 14K)
- Osteopathic treatment trigger numbers (PDF 27K)
What to do when a Read code does not have a defined Treatment Profile trigger number
Sometimes specific Read codes do not have a Treatment Profile trigger number compared to the broader Read codes they stem from, eg s50. has a trigger number of 12, but s508. has no trigger number. If you would like us to consider allocating the same trigger number for a specific Read code that applies to the broader Read code, please call our Provider Helpline on 0800 222 070, or email provider.help@acc.co.nz.
Last updated: 12 March 2012