Many factors influence which Rx Code Toniq suggests for a patient’s script, such as settings on the patient, prescriber, medicine, or institution the patient is in.
Patient Factors
Age
Toniq recommends script codes based on a patient’s age: Y (0-13 years), J (14-17 years), A (18-64 years), and the more recent S prescription code for patients 65 and over (see 1 July 2024 Budget Changes), to ensure they receive their prescriptions at the appropriate pricing. These may be changed depending on other settings below.
Note: the S code will only be recommended for scripts processed after 1 July 2024.
Rx Code
If a patient has an Rx Code set on their record (e.g. A1), this will override Toniq’s recommendations:
See Removing Rx Code from Patients.
‘4’ Reduced cost PHO
If this option is ticked on a patient, the script code on a dispensing will be 4 regardless of other factors, such as whether a patient has a CSC:
See Removing '4' Reduced Cost PHO from Patients in Bulk.
Entitlement Cards
If a patient has a Community Services Card (CSC), Prescription Subsidy Card (PSC), or High User Health Card (HUHC), Toniq will suggest 1, X, and Z script codes respectively.
PSC and CSC card fields are now automatically populated (see Automatic CSC and PSC Lookups via NES API) and will load against the patient even if the cards are not issued at your pharmacy.
Note: Automatic CSC and PSC lookup only works for patients with a validated NHI:
Not eligible for exemption
This option is on page 2 of a patient’s record. If set (e.g. if a patient is in prison) then they will not go exempt and get X-coded scripts, even if their script count goes over 20 items.
Prescriber Options
If a prescriber is set to Access, Interim, or Hospital PHO type the Dispensary program recognises them as an Approved Provider, but if this field is left blank, it assumes that they are not.
Toniq gives prompts and warnings accordingly unless Don’t check match of PHO status on Rx/Doctor is ticked on page 3 of General Options.
Institution Settings
When the Institution option Default Rx code to NS is ticked, it overrides other factors (such as the patient having a CSC) and suggests an NS Rx Code instead. The Service type of Prison also affects Rx Code recommendations.
Medicine Type
When a medicine is a subsidised oral contraceptive, Toniq will suggest O as the Rx code.
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