Error Messages FINAL

These error messages will be returned in the Operation Outcome Resource or in the ClaimResponse.error responses, where the response status = "R" - rejected. This is the standard FHIR mechanism for conveying errors.

The provider must take corrective action and re-submit the claim.

CPHA response codes FHIR mapping: ClaimResponse.error

Code System = http://pharmacyeclaims.ca/FHIR/CodeSystem/error-code Value Set = http://pharmacyeclaims.ca/FHIR/ValueSet/error-code

Note: Though we could logically separate these codes (eg some may be returned as HTTP errors or response codes) they will remain as they are in CPHA as the PMS vendors and adjudicators have already accounted for all of these error codes. Some may be deprecated over time and others may be added during implementation.

E.06.03 Response Codes

01=IIN error
02=version number error
03=transaction code error
04=provider software ID error
05=provider software version error
07=active device ID error
21=pharmacy ID code error
22=provider transaction date error
23=trace number error
30=carrier ID error
31=group number error
32=client ID # error
33=patient code error
34=patient DOB error
35=cardholder identity error
36=relationship error
37=patient first name error
38=patient last name error
39=provincial health care ID error
40=patient gender error
I1=beneficiary street address error
I2=city or municipality error
I3=province or state code error
I4=postal/zip code error
I5=country code error
I6=address type error