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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.

If this error code is received when the service codes submitted match the specialty selected, it is possible that your new sub-specialty has not been updated in the MoH system, or the incorrect rejection codes have been issued by the MoH. You are suggested to resubmit your claims as-is and if they get rejected again with the same error code, please contact the MoH (1-800-262-6524) for advice. 

 

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