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Find out moreThis Edition of Law Update, From Africa to Asia: Legal Narratives of Change and Continuity, takes you on a journey through dynamic markets.
Africa is undergoing a tech-driven transformation, overcoming regulatory challenges while its startup ecosystem thrives. India’s legal framework is evolving rapidly, keeping pace with its expanding economy and diverse business environment.
We also dive into China’s regulatory shifts, particularly how they are shaping investments in the MENA region, and explore Korea’s innovative global partnerships, which are driving advancements in industries across the UAE and beyond.
Read NowLast year the Council for Health Insurance (“CHI“) issued version 2 of the Saudi Billing System (“SBS“) and the Saudi Billing System Coding Standards (“SBSCS“), which was implemented on 1 June 2023 (“SBS V2“). SBS V2 includes additional codes to those in V1, including non-billable codes; take care not to miss these additional codes that are required to be coded.
However, while SBS V3 is not officially launched yet, CHI is conducting workshops to a preview and deeper understanding of the expected new classifications and governance frameworks. This article focuses on V2 of 2023.
SBS V2 (which includes SBS and SBSCS updates) updates and replaces the previously released “Standards and Guidelines of CCHI Billing System” of July 2020, and must be used in conjunction with the Australian Consortium for Classification Development (2017) Australian Coding Standards (“ACS“) (both standards are to be reviewed together). Thus, this updated document should be used in conjunction with ACS 10th Edition.
The SBS is a modification to the Australian Classification of Health Interventions (“ACHI“). According to CHI, the purpose of the SBS is to standardise data for claims, and for morbidity analysis and mandated reporting. CHI states that the SBS enables the translation of diagnoses and procedures and other health problems from words into an alphanumeric/numeric code, which permits easy storage, retrieval and analysis and use of the data.
Specifically, CHI reports that the ACHI codes have been modified for Saudi Arabia to allow inclusion of additional codes (including laboratory and pathology, ambulance and transport services, service codes or billing services) and further splits on unilateral/ bilateral procedures. SBS retains the same core 7-digit code as ACHI and includes two-digit extensions where greater specificity has been added to an ACHI code, including laterality.
The term ‘clinician’ is used throughout the document and refers to the treating physician but may also refer to midwives, nurses and allied health professionals
SBS V2 includes the following key updates:
The private health insurance market in Saudi Arabia is regulated by the CHI. To support the market, one of CHI’s strategic aims is to provide a standardized code set for billing interventions that providers submit to health insurers. The following healthcare services rendered in an ambulatory, secondary, or tertiary environment should be coded and billed:
The SBSCS are based on the ACS for the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (“ICD-10- AM“) and ACHI, both 10th Edition.
The SBS includes the following classification standards:
As of 01 January 2020, Saudi Arabia has mandated the 10th Edition of ICD-10-AM/ACHI/ACS. SBS is built on the Australian systems, specifically ICD-10-AM and ACHI, but differs from the Australian system in two fundamental ways, as reported by CHI:
Stay tuned for further updates on launching of V3!
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