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A4D - Invalid specialty for this service code

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Background:

The service code billed is allotted to a specialty which differs from the specialty set for the claim.

Solution:

  • Change the specialty of the service code, to the comparable service code corresponding to the specialty set for the claim (i.e., Change A445A - medical oncology (44) consult to A135A – Internal Medicine (13) consult).
  • Change the specialty of the claim to the match specialty of the service code, provided you are registered with the Ministry to bill in that specialty.

Note: You must be registered with the MoH to bill under a specialty, on or before the date(s) of service billed. If you bill codes under a specialty for which you are not registered, the claim will be rejected.

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