Manitoba Health Critical Response Codes

When Manitoba Health (DPIN) returns one or more critical response codes in the claim response message, the Critical Response Codes window will appear in Rx Detail. The critical response codes are:

  • ME1 Adverse drug interaction with severity level 1
  • MY Duplicate drug has been dispensed at a different pharmacy
  • MZ Duplicate therapy has been dispensed at a different pharmacy

The Manitoba Pharmaceutical Association Standards of Practice require that pharmacists intervene and/or respond to all MY and MZ response codes. Therefore the Critical Response Codes window provides the ability to submit an intervention code to Manitoba Health, in recognition of the critical response codes. This intervention code is submitted as a DUR claim, which updates the patient’s profile at Manitoba Health, but does not affect any financial information related to the claim.

To Submit a DUR Claim from the Critical Response Codes Window

The Critical Response Codes window opens once the Manitoba Health claim is completed. If the prescription was in the Queue, it will have status Incomplete and the window will appear when the prescription is opened in Rx Detail.

1. Select an appropriate intervention code from the drop-down list.

2. If required, select the appropriate Pharmacist Initials (this defaults to the same initials that are used in the Rx Detail Third Party tab).

3. Enter a note in the Rx Note field. (Optional)

4. Press the Submit DUR function button.

The DUR claim will be submitted to Manitoba Health and adjudication will continue with the next third party in the prescription’s billing code.

If a note was entered, it will be added to the Rx Detail Notes tab and will be identified by the heading Critical Response Code.

To Skip the DUR Claim in the Critical Response Codes Window

The Critical Response Codes window opens once the Manitoba Health claim is completed. If the prescription was in the Queue, it will have status Incomplete and the window will appear when the prescription is opened in Rx Detail. If you do not want to submit a DUR claim for the prescription, press the Skip DUR function button. A DUR claim will NOT be submitted to Manitoba Health and adjudication will continue with the next third party in the prescription’s billing code.

Comments entered in the Rx Note field are not saved when Skip DUR is pressed.

To Pend the Critical Response Code Prescription

The Pend function button provides the ability to store the prescription in the Pending tab on the Workbench. This allows the user to set the prescription aside until the pharmacist has time to deal with the prescription, or until the patient or doctor can be contacted.