MSP Explanatory Codes

A key part of medical billing in British Columbia is reconciling your Medical Services Plan (MSP) claims. Even the best billing agents experience the occasional error code and rejected claims. It’s frustrating but necessary to ensure payments are fair and accurate.

To help make things easier, we’ve compiled the MSP explanatory codes for you below. You can find the explanatory code using our unprocessed claims report and you can fix your rejected claim with MDBilling.ca. It just takes a few clicks and you’re done.

Below are the current explanatory codes that are included with every MSP claim that is rejected. There are over 700 codes! For easy navigation please use this menu:

*x MSP Explanatory Codes
Ax to Cx MSP Explanatory Codes
Dx to Fx MSP Explanatory Codes
Gx to Ix MSP Explanatory Codes
Jx to Lx MSP Explanatory Codes
Mx to Ox MSP Explanatory Codes
Px to Sx MSP Explanatory Codes
Tx to Vx MSP Explanatory Codes
Wx to Zx MSP Explanatory Codes
Numbered MSP Explanatory Codes

*x MSP Explanatory Codes

CodeDescription
*AOur records indicate patient deceased.  Please contact MSP.
*BPatient’s eligibility with MSP is in question.  Please have patient contact MSP.
*CMSP is unable to locate patient.  Please have patient contact MSP.
*DMSP has been unable to contact patient.  Please have patient contact MSP.
*EOur records indicate patient has permanently moved out of BC.  Please have patient re-apply for coverage if applicable.
*FPatient has opted out of MSP.  Patient should be billed directly.
*GOur records indicate MSP is not the primary insurer for this patient.
*HOur records indicate the patient requested coverage to be cancelled.
*IDate of service is prior to coverage effective date.
*LLab Volume Discount (excluded)

Ax to Cx MSP Explanatory Codes

CodeDescription
AAPHN is missing or invalid.
ABPHN is not on our records.
ACThis is not a valid PHN for MSP.
ADThis is an incorrect PHN for this patient.
AEThis claim is the responsibility of the interim Federal Health Program.
AFThis patient does not have coverage for the DOS.
AGThis service billed as “A Donor” coverage.
AHDependent number is missing or invalid.
AIDependent is not registered.
AJThis is an incorrect dependent number.
AKCoverage for this dependent has been cancelled.
ALThis dependent is not eligible for coverage with MSP.
AMDependent number and/or initial(s) do not match our records.
AOFirst name or initial(s) does not match our records.
APInitials and/or surname are missing or invalid.
AQSurname does not match our records.
ARBirthdate missing or invalid.
ASBaby not registered.
AUA claim for this service has been paid on the mother’s PHN#, under dependent #66.
AVTechnical difficulties with coverage check.  Contact Teleplan support.
AWClaim must be submitted with PHN.
AXProvince contacted, name and health number not matching.
AYProvincial/insurer or institution code missing or invalid or fee item not valid for insurer.
A1Patient signature required on pay patient account.
A2Patient address required on pay patient account.
A5Referred to or by doctor number is not valid for DOS.
A6Child is over-age for dependent 66.
A7Dependent 66 – PHN submitted is registered to male.  Please resubmit using mother’s PHN and dependent 66.
A9PHN not approved for ICBC claim number. 
BAInitials and/or surname changed to match BC Services Card.  Please confirm correct initials and surname with patient.
BBPHN changed to match BC Services Card.
BCSurname/initials and PHN changed to match BC Services Card.
BDChild not registered.  Processed under dependent 66.
BEPHN changed to newborn’s PHN.
BFClaim is held for future processing.
BGAmount adjusted to the rate effective for this DOS.
BHThis claim will be processed on a future remittance statement.  Please do not rebill.
BIFee item and diagnosis do not correspond.
BJFee item and amount billed do not correspond.
BKYour claim submission is being held pending WorkSafeBC notice of approval.
BLMassage therapy discounted.
BNThe maximum number of additional areas has been paid for this date of service.
BPBirthdate submitted does not match our records.
BRPlease clarify the date of service.
BUClaim was received prior to date of service.
BVService date exceeds allowable claim submission period.
BWHospital visits must be submitted with each month on a separate line.
BXClaim is being held pending ICBC notice of approval.
BZMSP has consolidated two PHNs held by this person.  Please update your records to the PHN indicated.
B2Previous PHN has been replaced with PHN indicated.  Please update your records.
B3In future, please bill multiple services of the same fee item on one line (eg. 13621 X 3; 09921 X 3)
B4Patient now has BC coverage.  Please contact patient and rebill under the correct PHN.
B5Child is over-age for billing under mother’s identity number under the reciprocal agreement.
CAFee item and time stated do not correspond. 
CBNumber of services and time stated do not correspond.
CCPlease state time anesthetic commenced.
CDDate of service and fee item billed do not correspond.
CEDOS was not a Saturday, Sunday or statutory holiday.
CFTime called or time service was rendered is missing or invalid.
CGEach service must be on a separate line.
CHPlease clarify billing; writing is illegible.
CINumber of services and amount billed do not correspond.
CJDate of service and amount billed do not correspond.
CKPractitioner number is invalid for this payment number and date of service.
CLPayment number is invalid for this date of service.
CMSpecialty is invalid for this date of service.
CNPractitioner is not registered with the College of Physicians and Surgeons or not active with MSP for this date of service.
COMSP is unable to request information by mail due to an invalid address on file. Please update your address with the College of Physicians and Surgeons of BC.
CPPractitioner status invalid for date of service and type of submission.
CQPractitioner is not licensed to bill for this service.
CR(531) WorkSafeBC incentive applied for proof submission.  Please refer to the contract for more information.
CS(530) WorksafeBC penalty applied for invoice submission. Please refer to the contract for more information.
CT(532) WorksafeBC amount adjusted to non contracted rate. 
CUWe are unable to process this account as this is an invalid referral.
CV(534) WorksafeBC penalty applied for proof timeliness. Please refer to the contract for more information.
CWTelephone advice fees may not be charged when another service was provided on the same day.
CX(529) Worksafebc Incentive applied for invoice submission. Please refer to the contract for more information.
CY(527) WorksafeBC invoice amount was adjusted to contract rate.
CZ(562) WorkSafeBC amount adjusted to $0.00 refer to fee schedule or contract.
C1Contact with invalid.
C2Special program name invalid
C3Assessment diagnostic invalid
C4Treatment plan prescription missing or invalid – please specify
C5Primary disposition missing or invalid.
C6(524) WorkSafeBC Daily maximum for good/service has already been reached.
C7(525) WorkSafeBC invoiced units reduced to approved units for good/service.
C8(528) WorkSafeBC invoice amount was adjusted to the Fee schedule.
C9(532) WorkSafeBC penalty applied for proof submission.  Please refer to the contract for more information.

Dx to Fx MSP Explanatory Codes

CodeDescription
DJThis claim is the responsibility of ICBC.
DPYour claim has been debited as our records show that the patient was out of province for the date of service.
DRDebit adjustment.  See secondary explanatory code(s).
DSAccount debited to agree with fee item paid to surgeon.  Please rebill for payment.
DVItem 00012 is not payable with laboratory blood work or visit fee charges to the same or an associated physician on the same date.
DWDebit adjustment of MSP claim as WorkSafeBC hospital emergency per diem rate billed for same date of service.
DXICBC has refused responsibility for your office visit. (insurer responsibility has been adjusted to MSP. Therefore, 13075 does not apply and has been withdrawn.
D0Match found for debit request record.
D1Debit request record did not meet Pre-Edit or Edit requirements.
D2No match found for debit request record.
D3Payment withdrawn per debit request record.
D4Unable to perform debit request at this time.  Claim is currently in process.  Please review account when processed.
D8Debit adjustment of account paid at GP rates.
D9Original claim is at WorkSafeBC and your debit request has been forwarded to WorkSafeBC.
EAFee items 00101, 12101, 12201, 13201, 15201, 15301, 16101, 16201, 17101, 17201, 18101 or 18201 are not payable to emergency room physicians.
EBStandby time is not payable by the Plan.
ECServices provided by the Canadian Blood Service are not a benefit of the Plan.
EDThere is insufficient medical necessity to process this claim.
EEThis service is not an insured benefit of the Plan.
EFNot a benefit under the Reciprocal Agreement.
EGThis service is the responsibility of WorksafeBC.
EHMileage is not a benefit except for unusual emergencies.
EIService not listed in the Payment Schedule. Please contact your Association.
EJServices at the request of a third party are not an insured benefit of the Plan.
EKClaim refused because the Assignment of Medical Services Plan Benefits to opted Out Practitioners form was not signed/dated.
ELClaim refused because the Assignment of Medical Services Plan Benefits to Opted Out Practitioners form was after the date of service (on the claim).
EMService unrelated to MVA injury.
ENClaim refused because of an inadequate medical record.
EP(512) WorkSafeBC service is not allowed with another service already paid on this date of service.  Please refer to the contract.
ER(520) WorkSafeBC pre-requisite item not received or rejected.  Please check contract for pre-requisite required and your previous billing information.
ESThis claim has previously been paid to the patient.
ET(516) WorkSafeBC invoiced units reduced to remaining approved units.
EXThis claim has been paid as a WorkSafeBC account.
EZThese fees are not a benefit when used for overtime compensation.
E1This service appears to be performed during your APP contracted hours – therefore it is not billable to MSP.
E2(521) WorkSafeBC limit 1 form 8 per claim, rate adjusted to Form 11 fee.
FAPrevious claim incorrectly refused/adjusted by the Plan.
FBThis is a duplicate claim.  An identical claim is being processed.
FCThis account has been paid or refused in accordance with previous correspondence, phone call or note record.
FEPayment adjusted per information received.
FFPayment for the full fee has been paid to another physician; we do not split the fees.
FGAge of patient does not correspond with the fee item billed.
FHService by definition is bilateral or multiple.
FIServices rendered to a physician’s own family member are not payable.
FJ00112, 01200-01202 only applies to the first patient treated.
FKThis account was billed under the wrong PHN or dependent number.
FLProfessional/technical fee paid to another facility.  Total fee not payable.
FMRepeat graded exercise tests require an explanation of the medical necessity.
FNPreviously paid service(s) considered to be included, have been deducted.
FOThe sex of the patient does not correspond with the fee item/diagnostic code.
FPThis patient’s care is restricted to another physician. Please refer to the MSP bulletin.
FQAdjustment made because of additional information received.
FRSee explanatory letter.
FSService is refused or adjusted.  Information requested has not been received.
FTAdditional information was not received.
FVThis service is included in a previously paid item.
FWRebilling submitted to change insurer responsibility.
FXThis is a reciprocal claim.
FYThis claim normally requires manual processing.  It has been computer paid and is subject to review at a later date.
FZThis claim normally requires manual processing but has been computer adjusted or refused.  If you disagree please resubmit with details in the claim comment/note field.
F1Included in WorkSafeBC hospital emergency per diem rate.
F2Time/date does not correspond with related claims.
F3Your rebilling is being processed.
F4Operative/procedural report does not substantiate the fee item billed.
F5Group therapy is not paid for more than one member of a family per session.
F6Please check patient identification.  This card has been reported lost or stolen.
F7Payment records show that this patient is seeing multiple general practitioners.
F8An adjustment is in process for the remainder of this claim.
F9Payment/refusal of the original claim cannot be reviewed until receipt of a rebilling plus additional details and/or operative/pathology report, if applicable.


Gx to Ix MSP Explanatory Codes

CodeDescription
GAA new consultation is not allowed when a group of physicians routinely working together provide a call for each other. Your claim was refused or reduced.
GBA referral had not been received at the time of processing.
GCA major consultation is not payable if the patient has been seen within 6 months for the same condition.
GDThis item is payable once per hospitalization. Otherwise, consultation preamble rules apply. If you disagree with this refusal please resubmit with a note.
GEClaim has been refused or adjusted as the service is included in the dialysis fee.
GFAs there is no indication of medical necessity for a new consultation, your account has been adjusted to the appropriate visit fee.
GGThis fee is included in the consultation or visit fee.
GHConsultation/visit is included in the fee for the procedure.
GJOur records indicate this is a referred case.
GKReferral now received.
GLA consultation is not payable to the family physician.
GMSpecialist discharge care plan for complex patients has already been paid to you or another specialist.
GNSpecialist discharge care plan for complex patients is only payable on inpatients.
GOSpecialist advance care planning discussion is not paid while patients are receiving critical or intensive care in the hospital.
GQReferral now received.  Computer generated code.
GRDirective care is payable at 2 visits per week.
GSDirective care is payable after surgery unless the patient is seen for a different condition.
GT(250) WorkSafeBC refused – Electronic report submission.  Incomplete form transmission.
GU(508) WorkSafeBC – payee is not authorized for date of service.  For more information contact Corporate and Health Care Purchasing.
GV(514) WorkSafeBC service is not approved or outside allowable entitlement period. 
GW(501) WorkSafeBC information missing.  Please resubmit with missing information.
GYThis consultation has been paid although it looks like transfer of care (> 3 consults/same specialty in 14 days).
G1(157) WorkSafeBC refused – Electronic report submission included an invalid date format.
G2(201) WorkSafeBC refused – Electronic report submission incomplete.  Required information missing, employer’s name.
G3(563) WorkSafeBC GST amount exceeds maximum allowable amount.
G4(209) WorkSafeBC refused-electronic report submission incomplete, required information missing, employees address.
G5(227) WorkSafeBC refused electronic report submission incomplete required information missing, estimated time off work.
G6(233) WorkSafeBC refused – electronic report submission incomplete.  Required information, work restrictions.
G7(564) WorkSafeBC  total amount must be greater than Federal tax amount.
G8(565) WorkSafeBC total amount must be greater than Provincial tax amount.
G9(566) WorkSafeBC PST amount exceeds maximum allowable amount.
HAThis claim has been paid to you.
HBThis claim has been paid to you.  Please note the change in name/PHN.
HCThis claim has been paid under the indicated fee item.
HDThis claim has been paid to an associated doctor or alternate payment number.
HEA retro adjustment has been applied to this paid claim.
HFThis account has been paid to the physician providing LOCUM services.
HGYour account has been refused or debited as the patient was out of province on
HHPayment reversed at the request of WorksafeBC.
HIReferral has now been received. Payment will remain at specialist rates.
HJThis fee has been paid to another physician or facility.
HKCredit Adjustment- See secondary code for explanation.
HLThis claim has been paid for a different date of service.
HMThis claim does not meet the over-aged submission requirements.
HNThe information provided does not correspond with our records on file.
HOThis claim was paid as an ICBC account.
HPYour note comment/correspondence has been considered, however, we are unable to alter our previous decision.
HQComputer generated credit.
HRThis procedure is normally performed once in a life time.  Please resubmit with an explanation for the repeat procedure.
HSA credit adjustment has been processed for this claim.
HTThis account has been overpaid in error.
HUPreviously paid amounts for individually billed services exceed per diem rate.
HVA claim for this service has previously been processed.
HW(507) WorkSafeBC duplicate service.  A service was already paid for this date of service.  Please do not rebill.
HXThis claim has been paid to you.  Computer refusal.
HYBalance payment.  Amount previously paid for individually billed services deducted from per diem rate.
HZPayment for this account was previously withdrawn per your debit request record.  If requesting payment, please resubmit with an explanation in your note record.
H1Daily volume limit exceeded.  Payment discounted by 100%.
H5Daily volume limit exceeded.  Payment adjusted.
H8Daily limit exceeded, paid at 50%
H9Daily limit exceeded, paid at 25%  
IA“B” prefixed or asterisk items are included in visit/procedure fee.
IB00012/90000 is not payable when performed with other blood work.
ICMultiple injections are paid to a maximum of three per sitting.
IDClaims for 00081 must be supported with details of bedside/resuscitative services.  Please provide break down on a per ½ hour basis.
IEThe Tariff Committee has not recommended approval for this tray service.  Patient may be charged for costs.
IFA visit fee is not payable with subsequent injections.
IGFee is not applicable unless the physician is called from another site to render the emergency service.  Resubmit with details of where you were called from.
IHThe consult or visit constitutes the first half hour of care.
IIMisc fees must be supported with details of the service provided.
IJ00083 cannot be billed alone. Your claim has been adjusted to the appropriate visit fee.
IKDuration of visit is required for this service.
IL00081 includes any minor procedures performed at the same time.
IMThis service charge is not applicable for the time/date and/or the item billed.
IN01210 – 01212 are not payable with diagnostic procedures.
IOPaid according to the time and/or duration stated.
IPCounselling and visit fees related to substance abuse disorder within 6 days of fee item 00039-Management of Opioid Agonist Treatment (OAT) are not payable. 
IQRefractory period is 30 minutes for non-operative continuing care surcharges unless for CCFPP care.
IRMinor tray fee not applicable.
ISMajor tray fee not applicable.
ITTray fee not applicable with fee item billed/paid.
IUTray fee not applicable when service performed in a Ministry funded facility.
IVTray fee not payable to hospitals or extended care facilities, etc.
IWThe Tariff Committee has recommended approval for the addition of this tray service.
IXThe Tariff Committee has not recommended approval for the addition of this tray service. Included in overhead.
IYTray fee to be billed by physician performing procedure.
IZMini tray fee not applicable.
I0ICBC has refused responsibility for this claim, therefore, MSP has accepted responsibility.  The insurer code has been changed.
I1Please resubmit with details of the emergency call-out.
I201210 – 01212 are not billable with non-emergency procedures.
I301200-01202 and 01205-01207 and 01215-01217 only apply when the physician is specially called to render emergency or non-elective services.
I4Please resubmit the remainder of this claim under the applicable fee for continuing care, according to the time indicated.
I5Emergency visits/surcharges are not paid for routine call backs.  Please resubmit with details of the medical necessity for additional emergency services.
I6Claims for 00082 must be supported by details of the care provided to critically ill patient.  Please provide breakdown on a per ½ hour basis.
I7Only one tray fee is applicable when multiple procedures are performed.
I8Another physician has claimed 00039 -Management of Opioid Agonist Treatment (OAT) during the same time period. Re-bill with additional information.
I9ICBC has refused responsibility of this claim.


Jx to Lx MSP Explanatory Codes

CodeDescription
JAMultiple diagnostic procedures are paid at 100% for the larger fee and 50% for the lesser.
JBIf a diagnostic procedure takes place on a subsequent visit within 30 days, only the diagnostic procedure is paid.
JCThe annual limit has been reached.
JDFee items 00931 – 00936, 00942, 00943 are paid at 100 percent when billed together.
JEPayment has been made at the appropriate per diem rate based on date(s) and sequence of associated claims.
JFWhen the patient acuity level changes up or down, the appropriate second day rate applies (01521 01522 or 01523).
JGServices for pain control/acute pain control are included in Critical Care fees for ventilatory support and/or comprehensive care.
JHA claim for critical care has been received from another practitioner. If you are not part of the critical care team please rebill with details.
JIThere is insufficient medical necessity to process this claim.  Resubmit explaining the need for services outside the critical care team, if applicable.
JJWritten support for medical necessity is required to pay critical care fees within the post-op period.  Resubmit with additional information if applicable.
JKInformation provided does not meet the criteria for the critical care fee item billed.  Please resubmit with additional information, if applicable.
JLSubsequent non-inclusive surgical procedures rendered by a member of the critical care team are paid at 75%.
JMDay 1 rates have been paid to you or another physician. Please rebill and provide details if patient transferred from a different city/hospital.
JNCritical Care schedule fee items are not payable within the duration of a general anesthetic.
JOTo be considered for payment claims for fee items 00081/00082 in lieu of critical care fees must be accompanied by a written explanation of medical necessity.
JPCritical Care ventilatory support (01412-01442) has been paid to another physician.  Your claim has been paid/refused according to the Section Preamble.
JQDay 2 rates for Critical Care apply when patient is re-admitted for the same condition.
JRCritical care (01411-01441) has been paid to another physician. Your claim has been paid/refused according to the Section Preamble.
JSDay 2 rates for critical care apply when the service is preceded by a consultation. 
JTClaims for percutaneous transluminal coronary angioplasty/additional vessel (00840-00842) are payable at 75% when billed by a team member.
JUComprehensive care (01413-01443) has been paid to another physician. Therefore, we are unable to process your claim for payment.
JVWhen a patient is admitted to NICU after 48 hours, second day rates will apply again (01521, 01522, 01523).
JW01200-01202 and 01205-01207 and 01215-01217 are not payable in addition to adult and pediatric critical care fees (01411-01441, 01412-01442 and 01413-01443).
JXWhen a patient is readmitted to NICU within 48 hours, billing continues at the same rate as if there were no break, unless there is a change in acuity level.
JYWhen a patient is readmitted to ICU within 48 hours with the same or similar problem, billing continues at the same rate as if there were no break.
JZWhen a patient is readmitted to ICU after 48 hours with the same or similar problem, day 2 rates apply.
J0(519) WorkSafeBC payee is not authorized to provide goods/services for more information contact corporate and health care purchasing.
J1(283) WorkSafeBC refused – report submission incomplete, required information missing, work location missing.
J2(568) WorkSafeBC HST not applicable for item.
J3(287) WorkSafeBC refused – report submission invalid, specific reference number invalid or missing.
J4(285) WorkSafeBC refused – report submission incomplete, required information missing, clinical information missing.
J5(281) WorkSafeBC refused – report submission incomplete, required information missing, worker’s city and or work location missing.
J6(279) WorkSafeBC refused – report submission incomplete, required information missing, injury description missing.
J7(277) WorkSafeBC refused – report submission incomplete, required information missing, patient duration missing.
J8(275) WorkSafeBC refused – report submission incomplete, required information missing, disabled from work flag missing.
J9(273) WorkSafeBC refused – report submission incomplete, required information missing, rehab program not indicated.
KAThere is no indication that two separate visits were made.  If two visits were performed, please provide times of each visit.
KBVisits and minor procedures, same diagnosis – larger fee only is paid.  Different diagnosis – lesser fee paid at 50%.
KCRepeat complete physicals within 6 months require an explanation of medical necessity.
KDThis service does not meet the criteria for fee item billed.
KEThis fee is applicable between 8 am and 6 pm.
KFPatient’s annual limit for counselling has been reached.
KGCounselling for two or more members of a family must indicate that they were seen individually.
KHOne 00114 is paid every two weeks for care provided in a long-term care institution (eg. nursing home, intermediate care facility) unless supported by an explanation.
KIAnother physician has been paid for daily hospital care.
KJThe total number of services exceeds the number of hospital days.
KKThis service is not a benefit of the Plan when performed in a hospital.
KLDaily care is payable up to 30 days only unless supported by additional information of the medical necessity.
KMSupportive care visits are limited to one visit for the first 10 days of hospitalization then one visit per 7 days per MSC Payment Schedule Preamble D.4.7.
KNOut-of-hospital care was provided during this time.  Please verify hospitalization dates.
KOIn-hospital care was provided during this time.  Please verify the dates.
KPLab, x-ray and/or interpretation fees are not a benefit under the Plan for a registered bed patient.
KQOur records indicate patient is located in a nursing home.  Please verify and rebill with the appropriate fee item.
KRHospital visits are not payable in addition to the routine care of a newborn.
KSHospital visits have been paid during the period you have billed nursing home care. Please verify location of patient.
KTNursing home visits have been paid during the time you have billed hospital care.  Please verify location of patient.
KUPlease resubmit the remainder of this claim, if applicable, under supportive or directive care.
KVEmergency Medicine fees and minor procedures – the lesser fee is paid at 50%.
KWFee item billed does not meet the criteria for group counselling.  The appropriate visit fee has been paid.
KXFee item billed is only applicable when service is provided in hospital emergency room.  The appropriate visit fee has been paid.
KYVisit fee includes examination/assessment of multiple diagnoses.
KZFee item and diagnostic code/note comment do not correspond.
K092515/92516 not payable with 92510, 92520-92544 or 92546.
K1Processed according to the Preamble to the Medical Services Commission Payment Schedule.
K2Processed according to the Section Preamble to the Medical Services Commission Payment Schedule.
K3Processed according to the description of the fee item, or the note relating to the fee item, in the Payment Schedule.
K4Please refer to the protocol for this fee item.
K5Your rebilling has been processed.  In future, please ensure that the necessary information (eg. “CCFPP” appears in the first line of your note record.
K6Primary base fee is not applicable.  Your account has been paid under the appropriate split base fee.
K7Patient not registered.  Payment for third and subsequent services will be reduced to 50%. (Primary Care).
K8Patient not registered – payment reduced to 50%. (Primary Care).
K9Our records indicate that fee item 00114/00115 is not applicable. Please verify the patient’s location.
LAVolume discount mechanism applied as per 2007 renewed lab agreement.
LBThis item is not a benefit of the plan unless performed in an MSC approved facility or as an outpatient service.
LCYour claim for fee item 13075 was refused as MSP has not received an associated claim from you or an ICBC visit (Must be for an unrelated condition)
LDNerve blocks/IV procedures are not paid with time units or procedures.
LEContinuous care by a second anaesthetist is paid under time fees only.
LFAnesthetic Procedural Fee Modifiers are not payable in addition to diagnostic or therapeutic anesthesia fees.
LGYour claim for fee item 13070 was refused as the WSBC visit was claimed for the same or a related condition.
LHAnesthetic procedural modifiers are only applicable to general, regional and monitored anesthesia.
LIYour claim for fee item 13075 was refused as the ICBC visit was claimed for the same or a related condition.
LJIntensity/complexity fees are not applicable to the surgical/diagnostic procedure(s) billed.
LKYour claim for fee item 13070/13075 was refused as a procedure was billed for the same or a related condition.
LL13052 is not applicable for a pre‑operative examination.
LMInsufficient medical necessity for two anaesthetists has been received.
LNPlease provide duration of continuous time spent with the patient during second and/or third stage s of labour only.
LOYour claim for fee item 13070 was refused as MSP has received a non WSBC visit claim from you.
LPFee items 01151 and 13052 are not applicable when performed in conjunction with other anesthetic services.
LQVisit fees are not payable at the time anesthetic services are rendered.
LRThis service is included in the annual complex care block fee.
LSAge related annual complex care block fee items must be provided on the same date of service as complex care planning fee item 14033.
LTThis service is not payable on inpatients who reside in a care facility.
LUYour claim has been refused due to an inadequate medical record.  The MSC Payment Schedule Preamble C.10 describes the requirements of an adequate medical record.
LVThis service is limited to once per calendar year per patient and has been paid to another practitioner.
LWThis service is only payable if the patient is seen and a visit billed on the same date.  Please resubmit for both services, if applicable.
LXFee item 33583 is for administering single parenteral chemotherapeutic agents and not for the injection of 1hrh.  Please resubmit using fee item 00010 if applicable.
LYClaim for Fee Item 32308/32318 has been paid as Fee Item 00308 as care has exceeded the first 10 days of hospitalization.
LZNot payable when the service is provided at the location (location code) indicated on the claim, and/or related claims.
L1(510) WorkSafeBC practitioner not authorized for date of service.  For more information contact corporate and health care purchasing.
L2(316) WorkSafeBC refused – duplicate form detected.
L3(517) WorkSafeBC invoiced units reduced to daily maximum for good/service.
L4(533) WorkSafeBC incentive applied for proof timeliness.  Please refer to the contract for more information.
L5(539) WorkSafeBC interest applied.
L9(509) WorkSafeBC practitioner number is missing or not recognized.  Please add or correct the information on the invoice and resubmit.


Mx to Ox MSP Explanatory Codes

CodeDescription
MAMultiple exams performed on the same visit, the lesser exams are paid at 50%.
MBA repeat refraction within a 6 month period requires medical necessity.
MCItems 02010, 02015 and 02012 include certain individual eye exams. 
MDExam and a minor procedure billed on the same day, the lesser fee is paid at 50%.
MEEye exams are not paid with office/hospital visits.
MFReferring doctor provided is invalid for payment of consultation billed.
MGThese exams are paid to a maximum of three per day.
MH02012 is not payable within three days of emergency surgery.
MIThe appropriate fees for removal of foreign bodies from the surface of the eye are 13610, 13611 or 06063
MJA fee item has been established for this service.  Please resubmit under the approved code.
MKFee item 13005 is not payable when the patient is a registered bed patient in an acute care hospital.
MLFee item 13005 may only be billed once per day per physician per patient.
MNFee item 13005 is not payable in addition to services provided on the same day/same physician/same patient.
MOA total fee has been paid to the same practitioner or payee.  Professional and technical fees are included in the total fee so your claim has been refused.
MPFee item 00109/13109 is not payable when a patient is admitted for surgery/delivery. The appropriate visit fee has been paid, if applicable.
MQFee item 00109/13109 is not applicable when a patient is referred for continuing care by a certified specialist.  The appropriate visit fee has been paid.
MRFee item 00109/13109 is not applicable when preceded by a complete physical exam within 7 days by the same physician.  The appropriate visit fee has been paid.
MSDoes not meet the criteria for billed services for hospitalized patients.
MTSub acute care has been paid during the period you have billed for acute/supportive care.  Please verify the location of the patient.
MVAcute/supportive care has been paid during the period you have billed for sub acute care.  Please verify the location of the patient.
MWThis RoadSafetyBC form fee is not payable on the same date of service as another RoadSafetyBC form fee that you have billed.
MXDriver’s license number is not numeric, is missing or is not located in the first seven spaces of the note or comment field.
MYA repeat RoadSafetyBC form fee is not payable to any practitioner within 3 months.
MZInsurer is invalid for this service.
M1(269) WorkSafeBC refused – report submission incomplete, required info, regular practitioner indicator missing or invalid.
M2(271) WorkSafeBC refused – report submission incomplete, required info, return to full duties indicator missing or invalid.
M3GPSC conference fee items 14015, 14016 or 14017 have been paid to you on the same date of service.  Therefore, this GPSC Fee Item is not applicable.
M4GPSC conference fee items 14015, 14016 or 14017 have been paid to a different GP on the same date of service so this GPSC fee is not applicable.
M5Specific GPSC fee items have been paid to you on the same or prior date of service so GPSC fee items 14015, 14016, 14017 and 14033 are not applicable.
M6Specific GPSC fee items have been paid to another GP on the same or prior date of service so GPSC fee items 14015, 14016, 14017 and 14033 are not applicable.
M7The GP daily volume limit was previously reached for this date of service. Please resubmit with explanation if you withdrew paid visits for this date.
NAPayable at 50% when billed with delivery fees.
NBFee item 14094 is payable once within 6 weeks following a C-section or vaginal delivery but not to the physician who performed the C-section.
NC04116 is only applicable in the immediate post-partum phase.
NDPre-natal visit fees are not payable within the post-natal period.
NEIncluded in the fee for delivery, caesarean section or post‑natal care.
NFPlease resubmit with an explanatory note record per the direction provided in the note(s) listed under the fee item.
NGAdditional prenatal visits must be supported by medical necessity.
NHIncluded in fee items 04025, 04050, 04052, 14108 and 14109. 
NIOnly one prenatal complete examination (00101/14090) is payable per physician per pregnancy.
NJMultiple call backs are not normally paid with delivery.  Provide details of serious complication(s) requiring additional emergency care.
NKTiming for fee item 14199 begins after two hours of continuous care during second stage of labour.
NLThis claim has been paid to the obstetrician.
NMThe incentive for full service GP obstetrical bonus is only applicable when fee item 14104, 14108 or 14109 is paid to the same physician/same day. 
NOItem 14000 is only payable when the physician attends one delivery on the date billed
NPFee item 14000 is payable for the first delivery the GP attends on the date billed, to a maximum of 25 bonuses per calendar year.
NQThe incentive for full service GP obstetrical delivery bonus is payable for the first delivery the GP attends on the date billed.
NRThe incentive for full service GP obstetrical delivery bonus is payable to a maximum of 25 bonuses per calendar year.
NSYou have reached or exceeded the practitioner calendar year limit for this service.
NTThe monthly limit has been exceeded.
NUThe BCP daily limit has been reached resulting in a partial or zero BCP premium being applied to this claim.
NVThis fee item is only payable to the physician who has provided the majority of the longitudinal general practice care to the patient over the preceding year.
NWThis fee item is not payable for services provided by physician who are working under a salaried, sessional or service contract arrangement.
NI(546) WorksfeBC debit request from payee.
N2(544) WorkSafeBC invoices received date and time cannot be in future.
N3(555) WorksafeBC invoices original amount cannot be negative.
N4(556)WorksafeBC invoice must be a debit.
N5(557) WorksafeBC invoice items created date and time cannot be in future.
N6(558) WorksafeBC invoice items created date and time cannot be on or before received date and time.
N7(559) WorksafeBC invoice total amount cannot be negative.
N8(560) WorksafeBC invoice items unit amount cannot be negative.
N9WorkSafeBC refused – call out charges not payable for service(s) billed.
OAPrimary and secondary wound management fees are only applicable with fees from the Orthopaedic Section.
OBConsult/visit is included in the paid claim on the same date of service by the same practitioner or payee for RoadSafetyBC fee item 96226 or 96227.
OCEye exam is included in the paid claim on the same date of service by the same practitioner or payee for RoadSafetyBC fee item 96226 or 96227.
ODVisual field test 02041, 02042, 02043 is included in the paid claim on the same date of service by the same practitioner or payee for fee item 96226, 96228.
OHAdjusted to the appropriate fee/amount for an open reduction and/or compound fracture.
OIExternal fixation is not payable with an open reduction fee.
OJRemanipulation is not payable to the same physician within five days of the initial procedure.
OLPrimary wound care management fees are not stand alone items.  Please rebill with the appropriate fracture fee if applicable.
OM51037/51038 is only paid with applicable orthopaedic section items.


Px to Sx MSP Explanatory Codes

CodeDescription
PA00622 has been paid for another dependent. This fee includes parental assessment.
PBConsultations for two family members or more require individual referrals and must be seen separately.
PCPsychotherapy sessions extending beyond one hour per day must be supported by an explanation of need.
PDFamily therapy is only payable on one member’s PHN.
PEInvalid service clarification code for psychiatry fee item.
PFInvalid service clarification code for Rural Retention Premium.
PGSpecialty invalid for Rural Retention Premium.
PHPCO Registration submitted for a PHN that is currently registered to an associated primary care organization.
PIAdjustment due to PHN registration change.
PJPHN not registered on service date.  Claim for a non physician and/or billed fee item does not meet conversion to fee for service criteria.
PKAdjustment due to PHC registration change E-debit only, no matching credit created.
PLRural retention is not applicable to the geographic location where the service was provided.
POBeneficiary reimbursement for services.
PWResubmit as extended services code (960xx) or MSP fee code with an explanatory note.
PZPlease resubmit with child’s PHN.  Consider registering PHN with the primary care organization.
P0Claim for a non-physician and/or billed fee item does not meet conversion to fee for service criteria.
P1Related claims have been paid by ICBC.  Please check your records and rebill using MVA indicator “Y”, if necessary.
P2Partial payment from ICBC for one service.
P3Related claims have been paid by WorkSafeBC.  Please check your records and rebill using insurer code “WC”, if necessary.
P5Not approved for service.
P6PHN not registered to primary care organization.
P7Invalid/missing date in note record.
P8PCO invalid registration cancel date/cancel reason code.
P9Registration not eligible for PCO site.
QAAn Operative Report is required to assess this claim.
QBAn Operative Report and the medical necessity is required to assess this claim.
QCThe medical necessity is required to assess this claim.
QDWritten support for two assistants is required from the surgeon.
QEService is within the pre or post‑operative period.
QFPre and/or post‑operative services have been deducted from this claim.
QGService is included in the composite surgical/procedural fee.
QHIndependent procedures are not payable with other services.
QI13612 is per laceration. If resubmitting, bill each laceration separately, and state length of any over 5 cm.
QJAdjusted to agree with the surgical/assist fee item paid for this date of service.
QKAssistance at surgery/diagnostic procedures usually performed by one physician is not payable.
QLAssists and visits are not paid together unless distinct unrelated times are provided.
QMMultiple procedures at the same time, the lesser fee(s) paid at 50%.
QNFee item requires pre-authorization.  Please resubmit with the operative/procedural report and provide details regarding the medical necessity.
QOA claim for surgical fee item G04705, G04707 or G04709 has not been received. Therefore, this gynaecological certified assist fee item is not applicable.
QPRepeat/staged procedures are not paid within designated time limit.
QQ77043 is not applicable according to the information provided.
QRA surgical surcharge is not applicable as the procedure billed is not considered a surgical item.
QS07019/70019/70020 requires confirmation of medical necessity from surgeon.
QTPayment at 75% is not applicable.
QUUnassociated multiple procedures at the same time, the lesser fee is paid at 75%.
QVA claim for surgical fee item G04709 has not been received therefore, G04713 second surgical assist in not applicable.
QWPre-approval is required for this fee item.  Please resubmit upon approval.
QXA new authorization is required after two years per Preamble D.9.1.1.  Please rebill after a new authorization is received, if applicable.
QYICBC refusal. No refusal reason code.
QZ77043 is only paid with applicable vascular surgery items.
Q1Long-term care institution visits have been paid during the time you are billing for home visits.  Please verify location of service.
Q2Home visits have been paid during the time you are billing for long-term care institution visits.  Please verify location of service.
Q3The first visit of the day bonus has been refused or debited as the corresponding visit has also been refused or debited
RAClaim has been paid under the composite fee 08547 which includes 08530, 08537, 08544 and 08545.
RBX‑rays billed by non-certified radiologists are paid at 75%.
RCYour rebilling has been refused.  A retroactive adjustment will be made on a future remittance statement.
RDPayment has been reduced as this fee item is paid on a “per case basis”.
REEncounter received.
RFEncounter required – patient registered to primary care organization.
RGEncounter record converted to fee for service.
RHAmount greater than $0 billed on an encounter record.
RIRGP fee for service.  Claims are not valid for dates of service greater than June 30, 1995.
RJRegistration must be submitted by a medical doctor.
RKFee for service record converted to an encounter record.
RLPayable only for approved procedures.
RMThe miscellaneous fee item billed has been changed to this established fee item.
RNDental/oral surgery with extractions – the higher gross fee item(s) are paid at 100% and extractions in the same quadrant paid as “each additional tooth”.
ROMultiple dental/oral surgeries are paid as the larger fee at 100%; the lesser fee at 50% unless otherwise stated in the MSP Dental Schedule.
RQThis fee item is payable once per jaw.
RSA claim for this service has been paid within the previous 12 months.
RTA claim for this service has been paid within the previous 12 months to another practitioner.
RUAmounts greater than $0 are not billable under this personal health number.
RVThis patient has not been seen face-to-face at least twice in the preceding 12 months. (This visit requirement excludes procedures, laboratory and x-rays).
RWThis item is not applicable unless continuous time is spent with the patient.
RXCritical care fees are not applicable when the service starts after 2200 hours.
RYThe maximum rate paid for these multiple laparoscopic operations is the rate payable for fee item 04229.  This service exceeds the maximum.
RZA visit is not payable in addition to a RoadSafetyBC or MSDSI form fee when the patient is seen for the same diagnosis.
R1(567) WorkSafeBC payment amount reduced to BC rates.
R2(154) WorksafeBC refused your claim submission. Transmitted record had a date of service prior to the date of birth.
R3(536) WorkSafeBC penalty applied for service timeliness. Please refer to contract for more information.
R4(569) WorksafeBC claim cannot be matched at this time. Please contact payment services at 604 276-3085 or 1 800 422-2228.
SBWorkSafeBC refused your claim submission – concurrent treatment not authorized.  If clarification required contact WSBC adjudicator.
SD(522) WorkSafeBC claim decision is pending.  Please resubmit when claim status is accepted.
SE(523) WorkSafeBC service is not allowed with another service already entitled on this claim.  Please refer to contract for contract terms.
SF(526) WorkSafeBC invoice date is greater than 90 days from date of service.
SJ(518) WorkSafeBC proof was not received or not accepted.  Please check contract for proof requirements.
SMYour claim has been refused.  Please resubmit with WorkSafeBC fee item for WorkSafeBC services.
SNThis service is the responsibility of WorkSafeBC. Please resubmit with “WC” insurer code.
SRInvalid fee item for WorkSafeBC claim.  Please resubmit using the appropriate MSP/WorkSafeBC fee item.
SX(551) WorkSafeBC payee not contracted to provide service.
SZ(147) WorkSafeBC refused claim.  Invalid body part code.  Please resubmit with amended information.
S1(146) WorkSafeBC refused claim.  Invalid nature of injury code. Please resubmit with amended information.
S2(148)WorkSafeBC refused claim.  Invalid side of body code.  Please resubmit with amended information.
S3(542) WorkSafeBC payee could not be matched.
S7(155) WorkSafeBC refused you claim submission.  Transmitted record had a date of injury prior to the date of birth.


Tx to Vx MSP Explanatory Codes

CodeDescription
TAPatient’s annual limit for this benefit has been reached.
TBThis fee is paid only once per patient, per year.
TCBalance owing on previously paid account.
TDLess than 3 months have elapsed since the last visit for this condition.
TELess than 21 days have elapsed since the last visit for this condition.
TFLess than 3 months have elapsed since the last paid treatment.
TGAs no authorization has been received, your account has been refused.
THFee item 02897 is included in fee items 02888, 02889, 02898 and 02899.
TJInvalid phn/fee item combination: phn 9824870522 only valid for fee 14010, phn 9825238602 only valid for fee items 36062, 36063, 36064, 36065 .
TKThis item is not applicable until the MSP age appropriate counselling fee item (00120, etc) calendar year limit (4) has been utilized.
TLICBC approved claim with referring doctor number 99990. 
TMICBC approved claim with referring doctor number 99995. 
TOThis claim is the responsibility of ICBC.
TPPrevious visit within 6 months for same condition.
TRICBC claim is outside of approved treatment dates.
TSPayment has been made in accordance with the information provided by the referring physician.
TTAuthorized payment amount has been reached.
TUDetails required for frequency of servicing. Please resubmit with explanation in note record.
TVService included in initial examination.
TWPayment has recently been made to other optometrist for this service.
TXICD9 code does not match published list.
TZRetroactive adjustment.
T0Fee item 02888, 02889, 02898 and 02899 are included in fee items 02894 and 02895.
T1Extractions in conjunction with osteotomies/fractures – bill extractions as “each additional tooth per quadrant” regardless of the number of quadrants involved.
T2Please resubmit with location of each of the extractions, lesion, etc.
T3A1234565 is not an acceptable ICBC claim number.
T4ICBC refused.  This may be a WorkSafeBC claim.  Please contact ICBC.
T5Services exceed ICBC coverage limit.  Please contact ICBC.
T6ICBC refused responsibility.  Please contact adjuster.
T7Therapy treatment discontinued by medical practitioner. Please contact ICBC.
T8Claimant has private plan for therapy.  Please contact ICBC.
T9ICBC customer unknown – please contact ICBC.
UAThis claim was assessed by the Plan’s Medical and Surgical Advisors.
UBClaim has been paid/refused pending review by our Medical Advisors.  You will be notified of any changes.
UCIf you disagree with the payment made, please refer to the appropriate committee of the DOCTORSOFBC (BCMA).
UDPaid according to Reference Committee recommendations.
UEComputer processed in accordance with Medical Services Commission Payment Schedule.
UFInvalid MVA – no injury claim.
UGBreach of ICBC coverage.
UHMVA prior to April 1, 1994. Contact ICBC if necessary.
UIDuplicate KOL 35 – contact ICBC if necessary.
UJNo ICBC claim for PHN – use ICBC number. Contact ICBC if necessary.
UL(515) WorkSafeBC the maximum service units entitled have already been invoiced.  Contact claim owner for more information.
UM(513) WorkSafeBC service is not entitled on claim. 
UPClaim refused as ICBC responsibility. Please rebill ICBC directly or if patient qualifies for MSP therapy benefits, please bill MSP.  ICBC claim # not required.
UQThis claim has been paid on an independent consideration and without precedent basis after review by MSP’s Medical and Surgical Advisors.
URPaid at the agreed fee amount.
U1Patient benefit limit reached – refractions are only payable once every 24 months for patients between the ages of 16 and 64.
U2A refraction has been previously paid to a different specialty – refractions are only payable once every 24 months for patients between the ages of 16 and 64.
U3Insufficient information has been provided to authorize a repeat refraction within 24 months.
U4Routine eye examinations are not a benefit of MSP.
U5Insufficient medical necessity provided for a repeat eye examination for the diagnosis indicated.
VAPayment number is missing or invalid.
VBInvalid payment number for tape or diskette submission.
VCPayment number not valid for this batch.
VEAmount billed is missing or invalid.
VFNumber of services is missing or invalid.
VGFee item is missing or invalid.
VHDate of service is missing or invalid.
VIPractitioner number is missing or invalid.
VJInvalid diagnostic code for referral by oral/dental surgeon or orthodontist.  Diagnosis must relate to problems with mouth or mastication.
VKClaim number is missing or invalid.
VLClaim number is out of sequence.
VMReferring practitioner number is missing or invalid.
VNDiagnostic code missing or invalid.
VOAnatomical position invalid or missing.
VPService to-date missing or invalid.
VQThe number of services exceeds the maximum allowed.
VRCritical care must be submitted on a claim form with a covering letter providing details to support the claim.
VSThe to/by indicator for the referring doctor is invalid.
VTClaim has been paid/refused pending review.  You will be notified of any changes.
VUNature of injury missing or invalid.
VVDate of injury missing or invalid.
VWWorkSafeBC claim number invalid or missing.
VXMedical practitioner referral required by ICBC.  Please contact ICBC.
VYArea of injury missing or invalid.
VZICBC claim number invalid for WORKSAFEBC claim.
V0Invalid diagnostic code for referral to an otolaryngologist from a dentist or pediatric dentist. Diagnosis must relate to neoplasms of lip, oral cavity or pharynx
V2Reserved for ICBC misc. adjustments where two bills are sent for one service.
V3Field(s) designated for future use contain(s) invalid data – refer to current Teleplan specs.
V4(533) WorksafeBC invoiced amount paid.
V6Services for this fee do not require a to-date. If services provided on different dates please submit as separate claims.
V7Services referred by de-enrolled practitioners are not a benefit of MSP.
V8Paid according to your MSP Orthodontia contract.
V9This patient is not user fee exempt for this date of service.


Wx to Zx MSP Explanatory Codes

CodeDescription
W$Work Safe BC claim submitted to Work Safe BC on paper.
WAService not approved for this payment number or date of service prior to approval date.
WB(541) WorkSafeBC claim could not be matched.
WCFee item not listed with Medical Services Plan.
WD(511) WorkSafeBC claim rejected or disallowed.  Do not rebill.
WEHospital payee claim submission refused.  Bill WorkSafeBC directly.
WFFee item billed and doctor’s specialty/practitioner number do not correspond.
WGFee items with letter prefix ‘A’ are not benefits of the Plan.
WHWe are unable to process a single claim for two different patients.
WIBilling is incomplete.  Please resubmit with all required information.
WKPlease rebill with initial fee for the first service and the additional fee for each additional service performed.
WNPre-authorization number valid.
WOPre-authorization number invalid.
WPPre‑authorization permits payment of this inactive coverage.
WQWorkSafeBC refused your claim submission – approval outstanding, pending time exceeded.  Please resubmit using code “W”.
WRPre‑authorized number invalid.
WS(561) WorkSafeBC service prior to injury.
WTTray fee not applicable to procedure billed.  Refer to the list of procedures eligible for a tray fee in the General Services Section of MSC Payment Schedule.
WUUnknown reason for refusal or change to fee item and/or amount.  Please contact WorkSafeBC.
W1Postal code missing or format invalid.
W2Data centre and payee number combination not on file.
W3Payee not active.
W4Use claims comment or note record.  Please do not use both.
W5Note data type not equal to “A”.
W6Note data line blank (no data).
W7Provincial institution not applicable for batch eligibility.
W8Dependent 66 not applicable for batch eligibility.
W9Greater than three errors for this claim.
X#Invalid sub-facility for this service type.
XARCP claims ‑ birthdate and sex code missing or invalid.
XBEligibility Request – invalid patient status request code used.
XCEligibility Request – invalid sex code.
XDInvalid or insufficient information provided. (In note or claim comment field/description area)
XEPractitioner does not have approval for this service. 
XFFacility does not have approval for this service.
XGNote comment does not correspond with submission code.
XHThis claim has been returned to you per your submission code E request record.
XJPlease resubmit on the appropriate claim form.
XKRCP/Registration Number is not numeric or is equal to zero.
XLWorkSafeBC claim number has been added/updated. Please contact WorkSafeBC for correct claim number.
XMPCO – ICBC has refused responsibility for this claim.
XNPCO – encounter record created to replace fee for service claim refused by ICBC.
XPICBC refused – claim processed by MSP.
XQPractitioner not attached to BCP Facility.
XSYour facility number was entered in the sub-facility field in error.
XWExpedited WorksafeBC surgical premium applied.
XYVendor test record returned.
X0Facility – Prac or Payee not connected.
X1Original MSP file number invalid.
X2Facility number is missing or invalid.
X3Sub-facility number is missing or invalid.
X4RCP/Institution number missing, invalid, or not in correct format.
X5RCP/Institution birthdate missing or invalid.
X6RCP/Institution first name missing or invalid.
X7RCP/Institution second initial invalid.
X8RCP/Institution  ‑ patient sex code missing or invalid.
X9RCP address missing or not showing in line one.
YANote record missing or invalid for submission code C, E or X.
YBThis Teleplan record code is not operational.  Please contact Teleplan Support.
YCClaim number refused by ICBC.  Please contact ICBC.
YDInsurer code does not match fee item billed.  This fee item is only applicable for ICBC billings.
YFFee item valid for WorkSafeBC claim only.
YHNo payment owing.  Insurer code adjusted.
YIProvincial institution not valid for WorkSafeBC claim.
YKClaim reprocessed at the request of WorkSafeBC.
YNNewborns invalid for WorkSafeBC claim – Dep 66.
YPWorkSafeBC claim must be submitted by PHN.
YRClaim reprocessed/adjusted at the request of ICBC to change insurer responsibility.
YSSpecialty invalid for WorkSafeBC claim.
YTWorkSafeBC claim must be Teleplan for opted in practitioner.
YUICBC refusal reason unknown – Please contact ICBC.
YVData Centre change.  Record submitted by previous data centre being returned to new data centre.
YWInsurer responsibility switched at the request of ICBC.
YXClaim reprocessed at the request of ICBC.
YYPre‑Edit System refusal.  See second explanatory code(s).
YZFacilities edit refusal.
Y1Billed fee prefix invalid.
Y2Payment mode is invalid.
Y3Submission code invalid.
Y4Service location code missing or invalid.
Y5Referring practitioner code 1 missing or invalid.
Y6Referring practitioner code 2 missing or invalid.
Y7Correspondence code invalid.
Y8MVA claim code invalid.
Y9ICBC claim number invalid.
ZINote record is not preceded by correspondence code equal to “N” or “B” or practitioner number does not match C01/C02 record.
ZJPHN equals zero and province code equals zero or blanks.
ZKA note record did not accompany correspondence code “N” or “B” or payee number does not match C02 record.
ZLRCP province code is present and PHN not equal to zero.
ZMCoverage good – batch eligibility. This code is used in Teleplan.
ZNNo coverage – batch eligibility.  This code is used in Teleplan.
ZSThe referring doctor number has been changed to correspond with our records.
Z5Referring doctor number has been changed to correspond with our records.
Z8Unable to process Ir1 or Ir2 record, zero payments returned to ICBC.
Z9ICBC reversal request denied – msp staff or data centre adjustment already created.
ZWWorkSafeBC Claim – Invalid PHN


Numbered MSP Explanatory Codes

CodeDescription
OBProvincial coverage limits payment to $75 CDN for out-of-country MRI scans.
1BThis fee item not valid for services provided in BC.  Please resubmit with appropriate fee item.
1WWorkSafeBC claim submitted to WorkSafeBC on paper – Work Safe BC adjusted – keying fee deducted.
2AChiropractic, Naturopathic, Optometric, Physiotherapy, Massage Therapy, Podiatry and Acupuncture services are not insured benefits outside of BC.

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