Intervention Codes

ODB - Ontario Drug Benefit

Message: Prescriber ID error

MH - override prescriber ID

Generic drug not available - dispensing brand name

MI - No interchangeable available at less than or equal to Drug Benefit Price plus allowable mark-up

Message: Maximum cost is exceeded

MO - valid claim value $500 to $999.99

MP - valid claim value $1,000 to $9,999.99

Message: Identical claim processed (Vacation Supply)

MV - vacation supply

Message: Drug/drug interaction potential

UA - consulted prescriber and filled Rx as written

UF - patient gave adequate explanation. Rx filled as written

UG - cautioned patient. Rx filled as written

UI - consulted other source. Rx filled as written

Message: Initial Rx Days’ Supply Exceeded

NH - Initial Rx Program Declined

Message: Quantity Reduction Required

NF - Override - Quantity Appropriate

Message: Patient first name error or Patient last name error

PB -name entered is consistent with card

Message: Exceeds max. # of prof. fees for this drug

UN - Assessed patient. Therapy is appropriate

Message: No Private Insurance Attestation Missing

U - Enter Special Service Code “U” if submitting a claim for a child/youth 24 years of age and under who does not have a private plan

Medically Necessary ODB No Sub Claims

Product Selection: - Enter reason code “1” to indicate prescriber-directed medically necessary “No Substitution”

Medical Condition/Reason for Use: - Enter “901” to indicate that a Side Effect Reporting Form has been completed and signed by the prescriber

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