Explanation for Refusal of RoadSafetyBC Form Fee - Ophthalmologists

The following chart is intended to assist ophthalmologists in understanding why a claim for a RoadSafetyBC Form Fee was refused by MSP.

Refused Fee Item Reason for the Refusal Explanatory Code
96226,96227, 96228 A claim for one of these fee items has been paid to another practitioner on the same date of service. HJ
96226 There is a paid claim for 96227 or 96228 on the same date of service by the same practitioner. MW
96227 There is a paid claim for 96226 or 96228 on the same date of service by the same practitioner. MW
96228 There is a paid claim for 96226 or 96227 on the same date of service by the same practitioner. MW
96226,96227, 96228 There is a paid claim within 3 months prior for the same fee item by any practitioner. MY
Consult, visit Consult/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. OB
02015,02017, 02018, 02019, 02020, 02038 Eye 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. OC
02041, 02042, 02043 Visual 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. OD
96226, 96227, 96228 The driver’s licence number is not numeric, is partially numeric, is missing or is not located in the first 7 spaces in the note or comment field. MX
96226, 96227, 96228 The RoadSafetyBC form fee was billed under the wrong insurer code-i.e. WorkSafeBC or ICBC MZ
96226, 96227, 96228 A duplicate claim has been billed. HA
96226, 96227, 96228 Patient age is less than 16 years old. FG
96226, 96227, 96228 Wrong specialty for the fee item billed. WF
96226, 96227, 96228 Practitioner not authorized to bill a visual fields test. CQ


Explanatory Codes

CQ - Practitioner is not licensed to bill for this service.
FG - Age of patient does not correspond with fee item billed.
FV - This service is included in a previously paid item.
HA - This claim has been paid to you.
HJ - This fee has been paid to another physician or facility.
MW - This RoadSafetyBC form fee is not payable on the same date of service as another RoadSafetyBC form fee you have billed.
MX - Driver’s licence number is not numeric, is missing or is not located in the first seven spaces of the note or comment field.
MY - A repeat RoadSafetyBC form fee is not payable to any practitioner within 3 months.
MZ - Insurer is invalid for this service.
WF - Fee item billed and doctor’s specialty/practitioner number do not correspond.
OB - Consult/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.
OC - Eye 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.
OD - Visual 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.