diff --git a/app/Http/Controllers/HealthCareSheetController.php b/app/Http/Controllers/HealthCareSheetController.php
index 8ca4c88..d3d02e1 100755
--- a/app/Http/Controllers/HealthCareSheetController.php
+++ b/app/Http/Controllers/HealthCareSheetController.php
@@ -1741,7 +1741,7 @@ class HealthCareSheetController extends Controller
             'exams.*.id' => 'nullable|integer|exists:nh_exams,id',
             'exams.*.act_id' => 'required_with:exams.*.id|integer|exists:nh_acts,id',
             'exams.*.description' => 'required_with:exams.*.id|string',
-            'exams.*.quantity' => 'required_with:exams.*.id|integer',
+            'exams.*.quantity' => 'nullable|integer',
             'exams.*.unit_price' => 'nullable|numeric',
             'exams.*.unit_quantity' => 'nullable|integer|min:1',
             'exams.*.to_delete' => 'nullable|boolean',
diff --git a/app/Http/Controllers/InvoiceController.php b/app/Http/Controllers/InvoiceController.php
index 2878624..55ba2cd 100755
--- a/app/Http/Controllers/InvoiceController.php
+++ b/app/Http/Controllers/InvoiceController.php
@@ -315,10 +315,10 @@ class InvoiceController extends Controller
                     return $this->errorResponse(trans('errors.nano_health_not_activated'));
                 }
 
-                $invoice->state = InsuranceSubscriptionState::ACCEPTED_MODIFIED;
-                $invoice->reason = $reason;
+                $invoice->state = 'MODIFIED';
                 $invoiceClone = $invoice->replicate();
-                $invoiceClone->state = InsuranceSubscriptionState::ACCEPTED;
+                $invoiceClone->state = InsuranceSubscriptionState::ACCEPTED_MODIFIED;
+                $invoiceClone->reason = $reason;
                 $invoiceClone->created_at = $invoiceClone->updated_at = $datetime;
                 $invoiceClone->push();
 
diff --git a/database/migrations/2022_04_08_102524_add_modified_state_to_nh_invoices.php b/database/migrations/2022_04_08_102524_add_modified_state_to_nh_invoices.php
new file mode 100644
index 0000000..685c3ad
--- /dev/null
+++ b/database/migrations/2022_04_08_102524_add_modified_state_to_nh_invoices.php
@@ -0,0 +1,35 @@
+<?php
+
+use Illuminate\Database\Migrations\Migration;
+use Illuminate\Database\Schema\Blueprint;
+use Illuminate\Support\Facades\DB;
+use Illuminate\Support\Facades\Schema;
+
+class AddModifiedStateToNhInvoices extends Migration
+{
+    /**
+     * Run the migrations.
+     *
+     * @return void
+     */
+    public function up()
+    {
+        Schema::table('nh_invoices', function (Blueprint $table) {
+            DB::statement("alter table nh_invoices
+    modify state enum ('UNDER_VALIDATION', 'ACCEPTED', 'REJECTED', 'ACCEPTED_MODIFIED', 'MODIFIED') default 'UNDER_VALIDATION' not null;");
+        });
+    }
+
+    /**
+     * Reverse the migrations.
+     *
+     * @return void
+     */
+    public function down()
+    {
+        Schema::table('nh_invoices', function (Blueprint $table) {
+            DB::statement("alter table nh_invoices
+    modify state enum ('UNDER_VALIDATION', 'ACCEPTED', 'REJECTED', 'ACCEPTED_MODIFIED') default 'UNDER_VALIDATION' not null;");
+        });
+    }
+}
diff --git a/resources/lang/en/states.php b/resources/lang/en/states.php
index 582804b..fbe939a 100755
--- a/resources/lang/en/states.php
+++ b/resources/lang/en/states.php
@@ -34,5 +34,6 @@ return [
     "SUSPENDED" => "SUSPENDED",
     "ONE_TIME" => "ONCE",
     "DAILY" => "DAY",
-    "MONTHLY" => "MONTH"
+    "MONTHLY" => "MONTH",
+    "MODIFIED" => "MODIFIED"
 ];
diff --git a/resources/lang/fr/states.php b/resources/lang/fr/states.php
index 7f1963a..2f54405 100755
--- a/resources/lang/fr/states.php
+++ b/resources/lang/fr/states.php
@@ -34,5 +34,6 @@ return [
     "SUSPENDED" => "SUSPENDUE",
     "ONE_TIME" => "1 FOIS",
     "DAILY" => "JOUR",
-    "MONTHLY" => "MOIS"
+    "MONTHLY" => "MOIS",
+    "MODIFIED" => "MODIFIÉE"
 ];