Caregiver Explanatory Codes
Here are the most frequently used explanatory codes found on WCB cheques/EFT statements to caregivers.
Medical Services Plan (MSP) Codes
BA Duplicate: payment has been made for a similar service provided on the same day.
BG Billed less than listed payment: appropriate payment for the date of service has been approved.
BQ Service code and/or amount submitted incorrect: please review and re-submit.
BW Billed more than listed payment: appropriate payment for the date of service has been approved.
CN Claim received more than twelve months after the date of service cannot be accepted for any reason.
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%.
KM Diagnostic procedure on the day of a 42 day procedure: diagnostic approved at 75%.
MS Billing would have to be submitted to MSP by the caregiver
Additional WCB Explanatory Codes
CR Credit of previously paid service: now seeking recovery.
HS Not WCB responsibility, please submit to Hospital Services.
IC Report incomplete: no report fee.
IJ Interjurisdictional Claim. This WCB claim is being handled in a Province outside of SK and will not be paid. Please resubmit to the accepting province for payment.
NA Not Authorized, Not Approved for payment.
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: invoice for report not paid.
NW More than one report received on a claim the same day: only one report fee payable.
TX No GST payable.
XT Cost transfer. Paid on incorrect claim number. Payment has now been reversed and re-issued on correct claim number.
1H Out-patient charge disallowed, same day as other service.
2H Out-patient charge adjusted.
2M Out patient and physiotherapy charge not allowed on the same day.
3H Out-patient charge disallowed – same day as admission.
4H In-patient charge adjusted to current rate.
5H Patient charge previously paid (duplicate).
6H Second outpatient same day, included in initial outpatient charge.
Please direct inquiries to Medical Accounts at 306.787.4412 or toll-free 1.800.667.7590.