How to Search for a Claim Exception

You can search for a claim exception by its code or its description. You can also search for claim exception codes that have a particular National Council for Prescription Drug Programs (NCPDP) reject code assigned to it. An exception code is assigned to the claim during adjudication and may indicate an error condition or provide additional information related to the processing of the claim.

Tip: If both Starts With options are selected for the Code and Description, the Starts With option for the Code takes precedence over the Starts With option for its Description.

Optionally, you can add a claim exception code.

To search for a claim exception or NCPDP reject code

1. On the Rules Mgmt menu, click Claim Exception.
2. On the Search Claim Exception page, click the appropriate tab, depending on the type of code for which you are searching:
   • Exceptions
   • NCPDP (claim exception code with a NCPDP reject code assigned)
3. On the selected tab, complete the field(s).

4. Click Search.

   If one match is found, it is displayed instead of the results table.

   If more than one match is found, a results table with matches is displayed. Click the up or down arrow next to a column heading to sort the table in ascending or descending sequence according to that column. Click a row to display that match.

   If no matches are found, a message is displayed with the option to click Reset to clear all fields and enter new search information. If too many matches are found, click Reset and search using additional options.

See Also

Search Claim Exception (Exception Tab) Page

Search Claim Exception (NCPDP Tab) Page

What Is Claim Exception?

About Rules Management

Version as of 5/16/14.