Exceptional Drug Status (EDS) - Manitoba

Manitoba Health and Manitoba Blue Cross both use Exception Drug Status (EDS). This allows patients to have certain drugs covered that aren’t a part of the formulary. The patient must meet specific criteria in order to use EDS. To submit a claim for an EDS drug, an intervention code must be used.

To submit a prescription for EDS drug:

1. In Rx Detail, select the Third Party tab.
2. Select Add. A new dropdown is added in the For Claim section.
3. In the dropdown, select the appropriate Intervention Code:
   • ED – Exception Drug Status Prescriber Choice: the prescriber has indicated on the prescription or verbally that EDS applies.
   • EP – Exception Drug Status Pharmacist Choice: the pharmacist has used their professional judgement to classify as an EDS prescription based on the drug’s specific criteria.

   

4. Select Fill to process the prescription.