Explanation for Refusal of RoadSafetyBC Form Fee - Physicians
The following chart is intended to assist physicians in understanding why a claim for a RoadSafetyBC Form Fee was refused by MSP.
|Refused Fee Item||Reason for the Refusal||Explanatory Code|
|96220, 96221, 96222||A claim for one of these fee items has been paid to another practitioner on the same date of service.||HJ|
|96220||There is a paid claim for 96221 on the same date of service by the same practitioner.||MW|
|96221||There is a paid claim for 96220 or 96222 on the same date of service by the same practitioner.||MW|
|96221, 96222||The claim was billed with a diagnostic code that was not equal to diabetes mellitus.||K3|
|96222||There isn’t a claim for 96220 billed on the same date of service.||KD|
|96220, 96221, 96222||There is a paid claim within 3 months prior for the same fee item by any practitioner.||MY|
|Consultation, complete exam, office or counselling visit||
Consultation, complete exam, counseling or office visit is included in the paid claim for RoadSafetyBC fee item 96220, 96221 or 96222 on the same date of service by the same practitioner for the same diagnosis. (or if general symptoms is the diagnosis= ICD9 code 780)
|96220, 96221, 96222||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|
|96220, 96221, 96222||The RoadSafetyBC form fee was billed under the wrong insurer code-i.e. WorksafeBC or ICBC||MZ|
|96220, 96221, 96222||A duplicate claim has been billed.||HA|
|96220, 96221, 96222||Patient age is less than 16 years old.||FG|
FG - Age of patient does not correspond to fee item billed.
HA - This claim has been paid to you.
HJ - This fee has been paid to another physician or facility.
KD - This service does not meet the criteria for the fee item billed.
K3 - Processed according to the description of the fee item, or the note relating to the fee item, in the Payment Schedule.
RZ - A consultation or visit is not payable in addition to a RoadSafetyBC or MSDSI form fee when the patient is seen for the same diagnosis.
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.