NEHTA Clinical Documents: ANZSCO codes

Aug 14, 2012

One of the coded values that appears throughout the NEHTA Clinical documents is ANZSCO (Australian and New Zealand Standard Classification of Occupations) codes. Most participants - particularly healthcare providers -  have a required code that indicates their occupation. This was not expected to be a problem because assigning an ANZSCO code is part of registration for an HPI-I, and therefore it was expected that sourcing the ANZSCO code would be straight-forward. However HPI-I take up is slow (see this Australian Article, or here if you aren’t registered). If there’s no HPI-I - and you don’t know the ANZSCO code for the provider - then what do you do? This leads you into an easily misunderstood area of ANZSCO itself. ANZSCO itself is available from the ABS Website. From here, you can download a PDF version of the ANZSCO codes. The PDF lists specific occupation codes, by code. Here’s a sample:

  • 253 Medical Practitioner
  • 2539 Other Medical Practitioners
  • 253911 Dermatologist
  • 253912 Emergency Medicine Specialist
  • 253913 Obstetrician and Gynaecologist
  • 253914 Ophthalmologist
  • 253915 Pathologist
  • 253916 Radiologist
  • 253999 Medical Practitioners nec

This sample shows the structure of the coding system - the digits work from the left providing levels of categorisation:

  • 2 - Professionals
  • 25 - Health Professionals
  • 253 - Medical Practitioner
  • etc

The problem is that the correct full 6 digit code is not known because of the missing HPI-I infrastructure. There’s an easily missed section of the PDF document that explains what to do in this case (page 19):

For example, responses which cannot be identified as relating directly to a particular occupation category, but which are known to be within the range of occupations within a particular unit group are coded to that unit group. Such responses are allocated an nfd code consisting of the four-digit code of the unit group followed by ‘00’. For instance, the response ‘Internal Medicine Specialist’ does not contain sufficient information to be coded directly to any particular occupation category, but it can be coded to Unit Group 2533 Internal Medicine Specialist, which encompasses all internal medicine specialists. It is thus allocated the code 253300 Internal Medicine Specialists, nfd.

So, if you don’t know what the exact ANZSCO code is, but you do know that the author is some kind of medical practitioner (this is a fact that operational clinical systems do generally keep, unlike the precise occupation), then you can assign the code 253000. This code will be the most commonly used ANZSCO code until HPI-Is start being widely used, though you could expect to see 250000 too.

I’m making this post because there’s some confusion about this - people using 253 instead of 253000, or systems not accepting 253000 as a valid code, etc.

p.s. Note the ANZSCO codes are another example of a code system that overlaps with nullFlavors, in that it defines the code 999999: “Not stated”

Update: two related questions around Revision 1 of the ANZSCO codes:

  • Does revision 1 apply? The specific reference to ANZSCO in the CDA implementation guides is “Australian Bureau Of Statistics, September 2006, 1220.0 - ANZSCO - Australian and New Zealand Standard Classification of Occupations, First Edition, 2006 - METeOR 350899, accessed 15 March 2010. [ABS2006] http://www.abs.gov .au/ausstats/[email protected]/mf/1220.0”. Given that revision 1 was released in 2009, it would appear to mean that revision 1 applies
  • Revision 1 doesn’t mention code “X” (i.e. 253111) so it isn’t valid anymore? This isn’t true - Revision 1 is a delta document - it only describes changes to the basic codes. Unless it specifically rescinds a code (deletion/merging), then the code remains valid. The only change in healthcare: 253916 Radiologist was retired (253917 and 253918 were added in it’s place)