List of Intervention Codes
Refer to the table below for a complete list of the intervention codes available for your pharmacy to select from.
Intervention Code | Description |
---|---|
BP | Bypass Processor Edit |
CA | Prior Adverse Reaction |
CB | Previous Treatment Failure |
CC | Allergy to Product is on Record |
CD | Therapeutic Duplication |
CE | Product Choice is not Reasonable |
CF |
Falsified or Altered Prescription |
CG | Rx Not Filled, Days Supply is unsuitable |
CH | Dangerously High Dose |
CI | Significant Drug Interaction |
CJ | Product is not Effective |
CK | Quantity Prescribed is not Rational |
CL | Sub-Therapeutic Dose |
CM | Suspected Multi-Pharmacy/Multi Doctor |
CO | Potential Overuse/Abuse |
CP |
Prescription is Too Old |
CS | Was Preauthorized by Telephone |
DA | Secondary Claim - Original to Provincial Plan |
DB | Secondary Claim - Original to Other Carriers |
DC | Out of Pocket Expense Paid by Insured |
DD | Out of Pocket Expense Paid by Insured Spouse |
DE | Adjudicate to $0.00 as Requested |
DF | Medication Billed Via Family Member ID |
DG | Same Product - Billed for Different Rx |
DH | Rx Synchronized Pursuant to Rule 19 |
DI | Advanced, Pharmacy Closed on Renewal Date |
DJ | Advanced, Unable to Deliver on Renewal Date |
DK | Exception, Drug Used in 2 Separate Locals |
DL | Exception, Need Drug for Medical Appointment |
DM | Exception, Renewal Preauthorized by RAMQ |
DN | Exception, Long-Term Rx Preauthorized by RAMQ |
DO | Changed Dosage - Dosage Too High |
DP | Drug Cost Verified - Invoice to Follow |
DQ | Professional Fee is Appropriate |
DU | For Drug Utilization Review Only |
EA | Pharmacist Authorized Off-Hours Claim |
EB | Supplementary Renewal - Prescriber Absent |
ED | Exception Drug Status Prescriber Choice |
EO | Early Renewal, Exception Status Indicated |
EP | Exception Drug Status Pharmacist Choice |
EQ | Valid Reason to Exceed Days Supply Limit |
ER | Override Days Supply Limit for a Period |
ED | Override Concurrent Therapy Requirement |
ET | Override Questionable Concurrent Therapy |
EU | Provincial Coverage Waived by Patient |
EV | Co-Pay Not Collected - Item is Exempt |
FA | Expect Treatment Period to Change |
FB | Second Service Required - Same Day |
FC | RAMQ Re-authorized Anticipated Renewal |
HT | Home Parenteral Therapy |
IA | For Asthma & Chronic Pulmonary Diseases |
IB | Chronic Pulmonary Disease is not Controlled |
IX | Covered Indication is Absent or Inconsistent |
LU | Start New LU Authorization |
MA | Prescriber Unavailable to OK 90 Days Supply |
MD | Prescriber Does Not Authorized 90 Days Supply |
ME | Valid Claim - Primary Validation Level |
MF | Valid Claim - Historical Validation Level |
MG | Override - Various Reasons |
MH | Override - Prescriber ID |
MI | No Interchangeable Available at Less Than or Equal to BAP + 8% |
MJ | Government Pharmacy Authorized Claim |
MK | Good Faith Emergency Coverage Established |
ML | Good Faith Standard Coverage Established |
MM | Replacement Claim, Drug Cost Only |
MN | Replacement Claim Due to Dose Change |
MO | Valid Claim - Value $500.00 to $999.99 |
MP | Valid Claim - Value $1,000.00 to $9,999.99 |
MQ | Valid Claim - Quantity Over Limit |
MR | Replacement, Item Lost or Broken |
MS | Non-Formulary Benefit |
MT | Trial Rx Program |
MU | Limited Use Product |
MV | Vacation Supply |
MW | Valid Reason to Exceed Good Faith Limit |
MX | Long-Term Care PRN Order |
MY | Long-Term Care Rx Split for Compliance |
MZ | Required Prior Therapy Documented |
NA | Valid Claim - Primary Validation Level |
NB | Valid Claim - Validation on File |
NC | Patient SDP Eligibility Confirmed |
ND | Trial Prescription Balance |
NE | Ineligible for Trial Rx |
NF | Override - Quantity Appropriate |
NG | Drug Interchanged - Y2K Shortage |
NH | Initial Rx Program Declined |
NI | Dosage Change |
NJ | Formulation Change |
NK | Directions for use Modified |
NL | Renewal of Prescription |
NM | Therapeutic Substitution |
NN | Emergency Supply of Medication |
NO | Emergency Contraceptive |
PA | Valid Health Card Version Code |
PB | Name Entered is Consistent With Card |
PC | Patient Does Not Meet Exception Criteria |
PS | Professional Care Service |
RC | Prescription Cancelled by Physician |
RE | Claim Reversed - Data Entry Error |
RR | Prescription Refused by Patient |
RU | Claim Reversed - Not Called For |
SL | Second Line Drug Prescribed by Specialty |
TB | ECO Therapy Lost, Broken or Spoiled by Patient |
TC | ECO Therapy Begun Friday AM at Hospital |
TP | ECO Therapy With Change of Dosage |
TR | ECO Therapy Lost, Broken or Spoiled by Carrier |
TS | Maintain Product Stability for Short Term |
UA | Consulted Prescriber and Filled Rx as Written |
UB | Consulted Prescriber and Changed Dose |
UC | Consulted Prescriber and Changed Instructions for Use |
UD | Consulted Prescriber and Changed Drug |
UE | Consulted Prescriber and Changed Quantity |
UF | Patient Gave Adequate Explanation. Rx Filled as Written |
UG | Cautioned Patient. Rx Filled as Written |
UH | Counselled Patient. Rx Not Filled |
UI | Consulted Other Source. Rx Filled as Written |
UJ | Consulted Other Sources Altered Rx and Filled |
UK | Consulted Other Sources. Rx Not Filled |
UL | Rx Not Filled - Pharmacist Decision |
UM | Consulted Prescriber, Rx Not Filled |
UN | Assessed Patient, Therapy is Appropriate |
UO | Valid Reason to Use Alternative Therapy |
UP | First Line Therapy Ineffective |
UQ | First Line Therapy Not Tolerated by Patient |
US | Patient Override of 90 Days - Financial Reasons |
UT | Treatment of Acute Condition |
UY | Extemp Mixture Dispensing Fee Limit Override |
UU | Therapeutic Emergency |
UX | Emergency Dispensing Fee Limit Override |
VC | Trial Rx Program Refused by Patient |
VD | Patient Unavailable to Receive Trial Rx Balance |
VE | Treatment of Acute Condition |
VF | Trial Rx Balance Urgently Needed |
VG | Professional Service Fee Not to be Paid |
VH | Trial Rx Refused by Physician |
VI | Trial Rx Refused by Pharmacist |
VJ | Trial Rx Refused by Patient's Agent |
VK | Trial Balance Not Filled |
VL | Consulted MD, Patient Return Requested |
VM | Trial Not Tolerated, Referred Patient to MD |
VN | Trial Not Tolerated, Patient Advised MD |
VO | Trial Ineffective, Referred Patient to MD |
VP | Trial Ineffective, Patient Advised MD |
VQ | Trial OK, No Side Effects/Concerns |
VR | Trial OK, Concerns OK After Counselling |
VS | Other Outcome or Intervention |
VT | Trial Not Required - Adequate Doctor's Sample |
VU | Do Not Contact Patient Re Evaluation |
VV | Patient Agrees to Evaluation Contact |
VW | Therapy Changed or Discontinued |
VX | Clinical Condition / Symptoms Improving |
VY | Patient Reports Side Effects or ADR |
VZ | More Time Required to Assess Therapy |
XA | Reversal Amount Error |
XB | Previously Rejected Transaction Not Found |
XC | Provider Transaction Date Valid for OLT |