Intervention Codes

Telus - ESI - Green Shield

ESI Intervention Codes

Step Therapy Program

UP - First-line therapy ineffective

UQ - First-line therapy not tolerated by patient

Telus Assure Intervention Codes

Trial for New Prescriptions

MG - trial drug program declined

Green Shield Canada Intervention Codes

Initial Days Supply for New Prescriptions

NH - initial Rx program declined

Vacation Supply

GSC allows vacation supplies to a maximum of 183 days

MV - vacation supply

Maintenance Medication Fill Limits

GSC will limit the number of fills to five per year for maintenance drugs included in the list.

ER - Override days’ supply limit for period

Early Refill: Dose Change

MN - replacement claim due to dose change

Claim Resubmission

NF - override quantity appropriate

For audit purposes, the pharmacy should document all relevant details about the prescription to support the selection of intervention code.