The SD flag is a specific type of service text that indicates that the item was Self-Determined. This means that the doctor performing the service was the one who determined the need for it. This overrides the usual requirement that a referral from another doctor is what initiates the service. A referred service can't be self-determined, and a service can't be self-determined if it has been referred by another doctor. For Eclipse claims, you can't use the SD flag if there is a referral date on the account.

 

For anaesthetists, the SD flag is usually used for diagnostic imaging items such as transoesophageal echo (55130) or ultrasound guided cannula insertions (55054).

 

All claims that include diagnostic imaging items also require an LSPN.