Care Provider Explanatory Codes 2018-09-04T15:14:56+00:00

Care Provider Explanatory Codes

Here are the most frequently used explanatory codes found on WCB cheques/EFT statements to caregivers.

Explanatory Code Description
AJ Payment adjustment has occurred.
BA Duplicate: payment has been made for the same service provided on the same day.
BG Billed less than listed payment: appropriate payment for the date of service has been approved.
BS The service code submitted is not correct for the condition described; or the service(s) provided. Appropriate payment for the date of service has been approved.
BW Billed more than listed payment: appropriate payment for the date of service has been approved.
CN  Invoice received more than twelve months after the date of service cannot be accepted for any reason. Payment has been denied.
CR  Previously paid service has been reversed resulting in an overpayment.
DA Only one visit type service is approved during a single patient contact. Payment has been denied.
DE Included in the payment for another service provided during the same Physician/Patient contact. Payment has been denied.
DI Claim is disallowed, please submit to Medical Services Branch (MSB).
FE The greater payment approved. (1) Procedure not approved in addition to another service. (2) Included in the payment for the procedure. Re: (1) Assessment Rules – “Multiple Services”, Rule 1. (2) Payment Schedule listing.
FP A “0” or “10” day procedure billed in addition to a visit/hospital care or consultation: approved at the greater of, the procedure alone or the visit plus the procedure at 75%.
HS  Not WCB responsibility, please submit to Hospital Services.
IC Report incomplete, payment has been denied.
IJ Interjurisdictional Claim. This WCB claim is being handled in a Province outside of Saskatchewan and will not be paid. Please resubmit to the accepting province for payment.
JO Paid in accordance with rules for two or more procedures performed on the same day by the same physician, another physician in same specialty and clinic or part of the surgical team. Re: Assessment Rules – “Multiple Services”, Rule 8.
KM Diagnostic procedure on the day of a 42 day procedure: diagnostic approved at 75%.
KP Visit (including hospital care) or consultation, same day, is included in the payment for a “42” Day procedure when provided by the same physician, another physician in same specialty and clinic or part of the team.
MS Not WCB responsibility, please submit to Medical Services Branch (MSB).
NA Not authorized, payment has been denied.
NM No Manufacturers invoice submitted. Please resubmit with the original invoice attached to your invoice for consideration of payment.
NR No report found on file for service date billed. Payment for report has been denied.
NW When multiple reports are received for the same claim on the same day, only 1 report is payable.
TX WCB is GST exempt therefore, no GST is payable.
XT Cost transfer. Paid on incorrect claim number, payment has been reversed.
XR Cost repayment has been made on the correct claim number.

For a complete list of explanatory codes, please visit the Medical Services Branch (MSB) website.

Please direct inquiries to Medical Accounts at 306.787.4412 or toll-free 1.800.667.7590.