Identify the service before the code
Start with what was delivered, who delivered it and the participant’s funding arrangements. A familiar item code is not enough to establish that the service, rate or claiming condition is correct for this record.
Use the version that applies to the service date
Check the official support catalogue and pricing arrangements for the relevant period. Look at the item description, unit, geographic conditions and any rules affecting the activity. Keep the version or reference your finance team used so a later reviewer can follow the decision.
Questions for the billing review
- Does the selected item describe the service actually provided?
- Does the participant’s arrangement support this billing route?
- Are the quantity, agreed price and applicable limit correct?
- Do travel or non-face-to-face components need separate review?
- Does the supporting note explain the work without adding invented detail?
Resolve uncertainty with the responsible finance or compliance person before submitting. Do not select a different code simply because the original line was rejected.
Keep software configuration current
Ask how your software handles catalogue changes and historical invoices. A new catalogue should not silently rewrite the basis of old records. Test the service date, selected item and export together with a fictional entry.
Use the official NDIS pricing documents for current rates and conditions. See the CordoCare billing review for the software steps around that decision.
