Consumer Real-Time Pharmacy Benefit Check FHIR IG
2.0.0 - CI Build

Consumer Real-Time Pharmacy Benefit Check FHIR IG, published by HL7 International / Pharmacy. This guide is not an authorized publication; it is the continuous build for version 2.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/carin-rtpbc/ and changes regularly. See the Directory of published versions

## ValueSet: RTPBC Error Code Value Set

Official URL: http://hl7.org/fhir/us/carin-rtpbc/ValueSet/rtpbc-error-code | Version: 2.0.0
Standards status: Trial-use Active as of 2020-05-23 | Maturity Level: 4 | Computable Name: RtbpcErrorCodeValueSet

This value set contains the error codes to be used by real-time pharmacy benefit check servers when encountering a data or business condition that prevents processing from completing. Values are defined in the NCPDP-maintained Reject Code (511-FB) code set.

References

- RTPBC Response Using ClaimResponse

### Logical Definition (CLD)

- Include all codes defined in `http://terminology.hl7.org/CodeSystem/NCPDPRejectCode` version Not Stated (use latest from terminology server)

### Expansion

No Expansion for this valueset (not supported by Publication Tooling)

Description of the above table(s).

### Notes:

﻿All codes are from the licensed NCPDP Reject Code (511-FB) code set, maintained by the National Council for Prescription Drug Programs. See NCPDP Reject Code (NCPDP ECL: 511-FB)

### Concept examples

The full, up-to-date content of the NCPDP Reject Code (511-FB) code set is only available to NCPDP members.

However, a past version of the code set is publicly available in the AHRQ United States Health Information Knowledgebase (USHIK). Below is a subset of concepts from that public source, for illustration purposes.

Code | Display
PJ | M/I Request Insurance Segment
1 | M/I Bin Number
4 | M/I Processor Control Number
6 | M/I Group ID
7 | M/I Cardholder ID
8 | M/I Person Code
600 | Coverage Outside Submitted Date Of Transaction
N1 | No Patient Match Found
99 | Host Processing Error
92 | System Unavailable/Host Unavailable
R8 | Syntax Error
21 | M/I Product/Service ID
77 | Discontinued Product/Service ID Number
ET | M/I Quantity Prescribed
26 | M/I Unit Of Measure
PZ | Non-Matched Unit Of Measure To Product/Service ID
19 | M/I Days Supply
22 | M/I Dispense As Written (DAW)/Product Selection Code
PN | M/I Request Prescriber Segment
DR | M/I Prescriber Last Name
25 | M/I Prescriber ID
56 | Non-Matched Prescriber ID
71 | Prescriber ID Is Not Covered
Z5 | M/I Service Provider Segment
5 | M/I Service Provider Number
YK | M/I Service Provider Name
PK | M/I Request Patient Segment
CA | M/I Patient First Name
CB | M/I Patient Last Name
9 | M/I Date Of Birth
10 | M/I Patient Gender Code