Insurance Intervention Codes Flashcards by Sarah Veloso

Q

DE

A

Adjudicate to $0.00 as Requested.

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Q

DL

A

Exception, Need Drug for Medical Appointment.

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Q

DU

A

For Drug Utilization Review Only.

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Q

ED

A

Exception Drug Status Prescriber Choice.

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Q

EP

A

Exception Drug Status Pharmacist Choice.

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Q

EQ

A

Valid Reason to Exceed Days Supply Limit.

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Q

ER

A

Override Days Supply Limit for a Period.

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Q

MV

A

Vacation Supply.

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Q

MX

A

Long-Term Care PRN Order

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Q

MY

A

Long-Term Care Rx Split for Compliance.

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Q

MZ

A

Required Prior Therapy Documented.

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Q

DA

A

Secondary Claim - Original to Provincial Plan.

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Q

DB

A

Secondary Claim - Original to Other Carriers.

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Q

CP

A

Prescription is Too Old.

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Q

CI

A

Significant Drug Interaction.

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Q

CG

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A

Rx Not Filled, Days Supply is Unsuitable.

Q

NN

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A

Emergency Supply of Medication

Q

RU

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A

Claim Reversed - Not Called For

Q

RE

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A

Claim Reversed - Data Entry Error

Q

UA

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A

Consulted Prescriber and Filled Rx as Written.

Q

UB

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A

Consulted Prescriber and Changed Dose.

Q

UD

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A

Consulted Prescriber and Changed Drug.

Q

UE

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A

Consulted Prescriber and Changed Quantity.

Q

UF

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A

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.

UQ

First Line Therapy Not Tolerated by Patient.

UL

Rx Not Filled - Pharmacist Decision.

UK

Consulted Other Sources. Rx Not Filled.