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

A

Rx Not Filled, Days Supply is Unsuitable.

Q

NN

A

Emergency Supply of Medication

Q

RU

A

Claim Reversed - Not Called For

Q

RE

A

Claim Reversed - Data Entry Error

Q

UA

A

Consulted Prescriber and Filled Rx as Written.

Q

UB

A

Consulted Prescriber and Changed Dose.

Q

UD

A

Consulted Prescriber and Changed Drug.

Q

UE

A

Consulted Prescriber and Changed Quantity.

Q

UF

A

Patient Gave Adequate Explanation. Rx Filled as Written.

Q

UG

A

Cautioned patient. Rx Filled as Written.

Q

UH

A

Counselled Patient. Rx Not Filled.

Q

UI

A

Consulted Other Source. Rx Filled as Written.

Q

UQ

A

First Line Therapy Not Tolerated by Patient.

Q

UL

A

Rx Not Filled - Pharmacist Decision.

Q

UK

A

Consulted Other Sources. Rx Not Filled.