Using Read Codes

Read Codes are a hierarchical coding system for injury types with each level giving a more specific diagnosis.

About Read Codes

Each Read Code has five characters. If a code only has four numbers, it will end in a dot, which becomes its fifth character.

Primary care providers are required to record Read Codes for all diagnosed injuries for ACC claims. Hospitals or secondary care providers can use International Classification of Diseases: 10 (ICDICD-10) codes instead, although can and often do also provide Read Codes.

Having the correct Read Code helps ensure we’re covering the correct injury/injuries and providing the client with the most appropriate and timely support, rehabilitation and treatment.

Choosing a Read Code

When completing an ACC claim form, eg.ACC45 Injury Claim Form, ACC 18 Medical Certificate, and ACC32 Request Approval for further treatments please:

  • use the Read Code that best correspond to your diagnosis of your patient’s injury
  • record the lowest relevant level of Read Code
  • use a separate Read Code for each injury for a client with multiple injuries in the order of severity/complexity
  • ensure that each Read Code includes the dot, if necessary.

If there’s no Read Code to match your diagnosis, use Code Z (unspecified condition) and provide a detailed written diagnosis. An ACC staff member will complete the Read Code field. If we need to clarify anything, a case owner will get in touch with you.

If you do not have access to the full Read Code directory via Read Code software, ACC can provide a quick Read code reference list sorted by type and location of injury if you need one. Use this link ACC6343 Read Code reference list (XLS 3.5M) to download the reference list. You can also follow these links for Read Codes commonly used in Physiotherapy, Osteopathy and Chiropractic.

Making a request to add or change a diagnosis

Adding a diagnosis to a covered injury

If, when you’re treating your patient, you discover an additional injury(s) related to the injury we’ve covered, you’ll need to request an ‘additional diagnosis’ before we can provide assistance for that injury.

Example: A client falls and sustains a shoulder injury. A claim has been lodged and accepted for the shoulder injury. However, you find out that they also sustained a knee injury in the fall, and you want to treat the knee injury under this claim.

Changing a diagnosis

We’ll consider a request to change a diagnosis if:

  • there has been an administrative error, eg a claim was lodged but for the incorrect body site
  • a change from an ICDICD-10 code to a Read Code
  • the initial diagnosis of the injury was incorrect.

Example: A claim was lodged with the lumber sprain Read Code S572. However there is now a confirmed diagnosis that the client has a lumbar disc prolapse with the radiculopathy Read Code N12C2.

How to add or change a diagnosis

To request that ACC change a diagnosis or add an additional injury, please submit an ACC 18 Medical Certificate or ACC32 Request Approval for further treatments.

When making your request, it is very important to provide sufficient information for a timely decision to be made.

If we don’t have enough information, the claim can be put on hold, or worst case declined pending further information. We don’t usually pay for claims with insufficient information to make a decision.

What Information does ACC need?

Where possible, please include the following information:

  • the date of the original event
  • the original injury diagnosis
  • description of how the new or additional injury would have occurred
  • the body site of the new injury
  • Read Code for the new /additional diagnosis
  • a description of the causal link from the original event and diagnosis/diagnoses and the new or additional diagnosis
  • medical evidence; eg clinical notes, reports, correspondence, x-ray, MRI and/or other scan to support your request.

What happens next?

An ACC case owner will review the information you have provided and consider your request. They may also seek further internal clinical advice for clarification. For example from an ACC branch medical advisor (BMA).

If we need to clarify anything with you, an ACC case owner will get in touch with you prior to a decision being made. They will contact you and the client when a decision is made.

Commonly used Read Codes

Read Codes commonly used in Physiotherapy

To assist with selecting the appropriate Read Code ACC has compiled a set of codes commonly used within your professional field for both registering claims and/or providing treatment.

Use this link ACC6344 commonly used codes in physiotherapy (XLS 96K) to download a copy.

This is a subset of the full list of Read Codes. If you can’t find a code that describes the injury for your patient, please refer to ACC6343 Read Code reference list (XLS 3.5M).

Read Codes commonly used in Osteopathy

To assist with selecting the appropriate Read Code ACC has compiled a set of codes commonly used within your professional field for both registering claims and/or providing treatment.

Use this link ACC6345 commonly used codes in osteopathy (XLS 178K) to download a copy.

This is a subset of the full list of Read Codes. If there is not a code that describes the injury for your patient, please refer to ACC6343 Read Code reference list (XLS 3.5M).

Read Codes commonly used in Chiropractic

To assist with selecting the appropriate Read Code ACC has compiled a set of codes commonly used within your professional field for both registering claims and/or providing treatment. Use this link ACC6350 commonly used codes in chiropractic (XLS 50K) to download a copy.

This is a subset of the full list of Read Codes. If there is not a code that describes the injury for your patient, please refer to ACC6343 Read Code reference list (XLS 3.5M).

Complete Read Code list

ACC can provide a quick Read Code reference list sorted by type and location of injury. Use this link ACC6343 Read Code reference list (XLS 3.5M) to download the full list of Read Codes.

Further information about Read Codes

Further information about Read Codes can be found in the Treatment Provider Handbook. If you require further assistance please call the Provider helpline on 0800 222 070.

Reviewed: 5 October 2015