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PharmaNet Response and Reject Codes

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PharmaNet attaches a standard Canadian Pharmacists Association (CPhA) response code to a claim when it returns the claim. The code shows how the claim was adjudicated or why it was rejected.

This guide groups the codes a pharmacy sees most, explains the Drug Use Evaluation (DUE) status codes, and lists the intervention codes that can override a normal adjudication.

Sources: Appendix A: Response Codes (PharmaCare Policy Manual) (read 2026-09-24) · What is PharmaNet (PharmaCare Policy Manual) (read 2026-09-24)

Read as Markdown

Where the codes come from

The Province of BC publishes the response code list as Appendix A of the PharmaCare Policy Manual. The CPhA Pharmacy Claim Standard holds the authoritative version.

Sources: Appendix A: Response Codes (PharmaCare Policy Manual) (read 2026-09-24) · What is PharmaNet (PharmaCare Policy Manual) (read 2026-09-24)

Data and identifier errors

These codes usually mean a field in the claim does not match a PharmaNet record. Correct the field and resubmit.

  • 19 Practitioner ID not found and 61 Prescriber ID error. Check the prescriber's registration ID.
  • 21 Pharmacy ID code error. Check the pharmacy ID sent on the claim.
  • 34 Patient DOB error and 39 Provincial health care number error. Check the patient fields.
  • 56 DIN/GP/PIN error. The product identifier does not match a PharmaNet record.
  • 58 Quantity error and 59 Days supply error.
  • 76 Pharmacist ID code error or missing.

Sources: Appendix A: Response Codes (PharmaCare Policy Manual) (read 2026-09-24)

Coverage and processing codes

Not every lettered code is a reject. Some report a paid or adjusted result.

  • A3 Identical claim has been processed. Do not resubmit the same claim.
  • B8 Prescription has expired and B9 Prescription has been adapted.
  • C3 Coverage expired before service and C9 Patient not covered for drugs.
  • D1 DIN/PIN/GP not a benefit and D7 Refill too soon.
  • D8 Reduced to generic cost. An adjusted payment, not a reject.
  • D9 Call adjudicator. The claim needs a manual review.
  • E5 Host processing error, please resubmit. E6 Host processing error, do not resubmit.

Sources: Appendix A: Response Codes (PharmaCare Policy Manual) (read 2026-09-24)

DUE codes are not rejects

The MA to NE series returns in the Drug Use Evaluation response status field. These codes flag a clinical risk for the pharmacist to review. They are not error codes.

  • ME Drug/drug interaction potential and ML Drug incompatibility indicated.
  • MF May be exceeding Rx dosage, MJ Dose appears high, and MK Dose appears low.
  • MH May be double doctoring and MI Polypharmacy use indicated.
  • MM Prior ADR on record and MN Drug allergy recorded.
  • MW Duplicate drug and MX Duplicate therapy. MY and MZ report the same flag at another pharmacy.
  • NC Dosage exceeds maximum allowable and NE Potential overuse or abuse indicated.

Sources: Appendix A: Response Codes (PharmaCare Policy Manual) (read 2026-09-24)

Intervention and exception codes

A claim carries intervention and exception codes in the ZCD segment. An intervention code can override normal adjudication rules where the circumstances fit. Appendix B of the PharmaCare Policy Manual lists the approved set.

  • RE Claim reversed, data entry error and RU Claim reversed, not called for.
  • RO Override alert, used to bypass a reject the pharmacist judges does not apply.
  • RR Prescription refused by patient, which supports a refusal-to-fill fee claim.
  • UA to UM series for prescriber consultation and pharmacist decision outcomes.
  • NL Renewal of prescription and NM Therapeutic substitution, used on adapted prescriptions.

Sources: Appendix B: Intervention Codes (PharmaCare Policy Manual) (read 2026-09-24)

How PharmFlow reads a response

The adjudication parser turns the PharmaNet response segments into structured fields. ZPB segments carry the money: plan paid, patient pays, deductible, and copay. ZPC segments carry DUE messages, which the parser maps to error, warning, or info severity. The ZZZ segment carries the response status.

PharmaNet access needs BC CIS onboarding and Keycloak credentials. The parser maps the codes. The pharmacist decides what to do with them.

Frequently asked questions

Is every response code a reject?
No. Codes such as D8 report a paid or adjusted result, and the MA to NE series are DUE status flags rather than error codes.

Sources: Appendix A: Response Codes (PharmaCare Policy Manual) (read 2026-09-24)

What does D9 call adjudicator mean?
The claim needs a manual review before it can pay. The pharmacist calls the claims adjudicator to resolve it.

Sources: Appendix A: Response Codes (PharmaCare Policy Manual) (read 2026-09-24)

When can a pharmacist use an intervention code?
When the circumstances fit the code, for example a claim reversal, a refusal-to-fill fee, or an override of a known duplicate. The code travels in the ZCD segment of the claim.

Sources: Appendix B: Intervention Codes (PharmaCare Policy Manual) (read 2026-09-24)

Which list of codes is authoritative?
The CPhA Pharmacy Claim Standard. BC republishes the codes in the PharmaCare Policy Manual for pharmacy reference.

Sources: Appendix A: Response Codes (PharmaCare Policy Manual) (read 2026-09-24) · What is PharmaNet (PharmaCare Policy Manual) (read 2026-09-24)

Sources