Reference · Billing

OHIP Error & Explanatory Codes

What that OHIP rejection code means - and what to do about it

By Dr. Alvin Chin, MD · Last reviewed June 2026 · Version 1.2

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Search by code or keyword to see what it means and what to do - the OHIP claim error and remittance explanatory codes physicians hit most.

Start typing to search all 414 OHIP error and explanatory codes in this reference. The full guide is below.

Showing 414 of 414 codes.

Code	Where / type	What it means	What to do
A1A	Error reportService, fee & diagnosis	Outside Service Period	This service falls outside the time window the fee code allows (for example a repeat assessment billed too soon). Check the timing rules in the Schedule of Benefits and bill the appropriate code, or fix the service date if it was entered wrong.
A2A	Error reportService, fee & diagnosis	Outside of Age Limit - Patient is underage or overage for this service code	Switch to the age-appropriate code for the patient and resubmit.
A2B	Error reportService, fee & diagnosis	Wrong Sex for Service - This service is not normally performed for this sex. Please check your records.	Check the patient’s age and sex against the code’s rules and bill the appropriate code.
A3E	Error reportService, fee & diagnosis	No such service code for date of service	Use a fee schedule code that exists and is valid for the service date, then resubmit.
A3F	Error reportService, fee & diagnosis	No fee exists for this service code on this date of service	This code isn't payable on that date - check its effective dates and use a code valid for the service date, then resubmit.
A3G	Error reportService, fee & diagnosis	Fee Billed Low	The fee submitted is below the Schedule amount - bill the correct (full) fee for the code and resubmit.
A3H	Error reportService, fee & diagnosis	Maximum Number Services per the Fee Schedule Master (FSM)	You've reached the maximum number of services allowed for this code - confirm the limit; only resubmit if a service was genuinely missed.
A3I	Error reportService, fee & diagnosis	X-Ray Code - Maximum Number Services per the Fee Schedule Master (FSM)	You've reached the maximum number of services for this X-ray code - confirm the limit before resubmitting.
A3L	Error reportService, fee & diagnosis	Other New Patient Fee Already Paid	A new-patient fee was already paid for this patient - bill a regular assessment instead of the new-patient fee.
A34	Error reportService, fee & diagnosis	Multiple duplicate claims	Duplicate claims were submitted - remove the duplicates and submit the service once.
A36	Error reportReferral & provider	Claimed by Other Practitioner	Another practitioner already claimed this service for the patient and date - confirm who saw the patient first; file a Remittance Advice Inquiry with documentation if it was you.
A4D	Error reportReferral & provider	Invalid specialty for this service code	Your specialty isn't eligible to bill this code - bill it under an eligible specialty or use the correct code, then resubmit.
AC1	Error reportService, fee & diagnosis	Maximum reached-resubmit alternate Fee Schedule Code (FSC)	Resubmit using the correct alternate Fee Schedule Code, or confirm the frequency limit hasn't been reached.
AC4	Error reportReferral & provider	Unaccepted Referral Number. Not 6 numerics Equal to the Practitioner billing number Referring number is 722900-744292 (Nurse Practitioner (NP)) and FSC is not eligible for NP referral. Referring number is 700000-722899 (Midwife (MW)) and FSC is not eligible for MW referral.	Correct the referral number - it must be 6 digits, not your own billing number, and from a provider eligible to refer for this code (note the NP and Midwife referral limits) - then resubmit.
AD3	Error reportService, fee & diagnosis	Not allowed with visit	This code can't be billed with a visit/assessment on the same claim - remove the visit (or this code) and resubmit.
AD5	Error reportService, fee & diagnosis	Procedure allowed previously	This procedure was already billed for the patient - confirm it isn't a duplicate before resubmitting.
AD8	Error reportService, fee & diagnosis	Not allowed alone	This code can't be billed on its own - add the base service it must accompany, then resubmit.
AD9	Error reportService, fee & diagnosis	Premium not allowed alone	This premium can't be billed on its own - add the base service it applies to, then resubmit.
ADF	Error reportService, fee & diagnosis	Corresponding Procedure Invalid, Omitted or Paid at zero	Add or correct the base procedure this code depends on - the corresponding procedure must be present, valid, and payable (not paid at zero) - then resubmit.
ADH	Error reportService, fee & diagnosis	Cannot be billed together	These codes can't be billed together - remove one of the conflicting codes and resubmit.
AH8	Error reportService, fee & diagnosis	Invalid Admission Date and/or Hospital number.	Correct the admission date and/or hospital number on the claim, then resubmit.
AHF	Error reportService, fee & diagnosis	Concurrent or Supportive Care Same Period	Concurrent or supportive care was already billed for the same period - only one physician's care is payable for that period; confirm eligibility before resubmitting.
AM1	Error reportService, fee & diagnosis	Service Limit Exceeded	The service limit for this code has been exceeded - confirm the cap; only resubmit if a service was genuinely missed.
AMS	Error reportService, fee & diagnosis	Multiple Procedures	Multiple procedures were billed - confirm each is separately payable (reductions may apply) and resubmit with the correct codes and units.
AO2	Error reportService, fee & diagnosis	Previous Obstetrical Service	OHIP shows a prior obstetrical service for this patient. Confirm the new service is separately billable; if it is, resubmit with supporting detail, otherwise it is already included.
AO3	Error reportService, fee & diagnosis	Most Responsible Physician (MRP) Visit Already Paid	An MRP (most responsible physician) visit was already paid for this patient and date - only one is payable, so don't rebill it.
ARF	Error reportReferral & provider	Missing Physician Referring Number	Add the referring physician's number to the claim and resubmit.
ARP	Error reportReferral & provider	Referring Physician Number Required	Add the required referring physician's number to the claim and resubmit.
ASP	Error reportService, fee & diagnosis	Not Allowed with Surgical Procedure	This code can't be billed with the surgical procedure - remove one of them and resubmit.
AT1	Error reportService, fee & diagnosis	Only One Modality Allowed	Only one modality is allowed - submit a single modality for the encounter and resubmit.
AT2	Error reportService, fee & diagnosis	Must Include Video Modality	This code requires a video modality - add the video modality (or use the code that matches the modality used) and resubmit.
AT3	Error reportService, fee & diagnosis	No Patient-Physician Relationship	This virtual-care code requires an existing patient-physician relationship. Bill the code for an unattached patient instead, or confirm the relationship criteria are met.
AT4	Error reportService, fee & diagnosis	Modality Not Allowed	The modality used isn't allowed for this code - use the correct code for the modality, then resubmit.
CNA	Error reportService, fee & diagnosis	Counselling Not Allowed	Counselling isn't payable here - remove the counselling code (it isn't allowed in this context) and resubmit.
EG1	Error reportReferral & provider	Group not Eligible	The group isn't eligible to bill this service - confirm the group's registration/eligibility for the date, or bill under an eligible number.
EH1	Error reportEligibility & health card	Service Date before Eligibility Effective Date	The patient's coverage hadn't started on the service date - confirm the eligibility start date; OHIP can't be backdated, so bill the patient or alternate payer if they were uninsured.
EH2	Error reportEligibility & health card	Mismatched Version Code	Get the current version code from the card or via Health Card Validation and resubmit. A renewed card's old code will never clear.
EH4	Error reportEligibility & health card	Service Date after Eligibility End Date	Validate the card. If coverage genuinely lapsed, bill the correct payer or have the patient update it at ServiceOntario.
EH5	Error reportEligibility & health card	Service Date Not in Eligibility Period	Confirm eligibility. If the patient was uninsured for that date, bill the patient or the appropriate alternate payer.
EH6	Error reportEligibility & health card	Eligibility Terminated-Deceased	Confirm the service date; if it falls after the date of death the service is not payable. Correct a data-entry error if that is the cause.
EH9	Error reportEligibility & health card	Health Number (HN) Not Activated	The health number isn't activated - have the patient activate it with ServiceOntario, then resubmit once it's active.
ENP	Error reportReferral & provider	Invalid FSC for Nurse Practitioner (NP)	This fee schedule code isn't billable by a Nurse Practitioner - use an NP-eligible code, then resubmit.
EPA	Error reportEligibility & health card	Network billing not approved	Confirm your group is approved for network / capitation billing for this service date. If it isn't approved, bill the service under the correct payment model.
EPC	Error reportEligibility & health card	Patient not rostered/rostered to another Network	The patient isn't rostered to you (or is rostered to another network) - confirm rostering; bill the appropriate non-rostered code if they aren't your enrolled patient.
EPF	Error reportEligibility & health card	Enrolment Date Mismatch	The enrolment date on the claim doesn't match the Ministry's record - correct the enrolment date and resubmit.
EPP	Error reportEligibility & health card	Incorrect Code for Eligibility (Ontario Works/Ontario Disability Support Program)	Use the correct code for the patient's eligibility program (Ontario Works / ODSP) and resubmit.
EPS	Error reportEligibility & health card	Patient Not Eligible for Program	The patient isn't eligible for this program - confirm their eligibility; bill the correct payer if they aren't covered.
EP1	Error reportEligibility & health card	Enrolment Transaction Not Allowed	This enrolment transaction isn't allowed - check the enrolment rules for the patient's status, then correct and resubmit.
EP2	Error reportEligibility & health card	Not for Enrolment/ReEnrolment	This code can't be used for enrolment or re-enrolment - use the correct enrolment transaction, then resubmit.
EP3	Error reportEligibility & health card	Incorrect Service Date – Check Date of Enrolment	The service date is inconsistent with the patient's enrolment date - check the enrolment date and correct the service date, then resubmit.
EP4	Error reportEligibility & health card	Enrolment Restriction Applied	An enrolment restriction applies to this patient - confirm their enrolment status and restrictions before resubmitting.
EP5	Error reportReferral & provider	Incorrect FSC for Group Type	Use a fee schedule code that is valid for your group or network type, then resubmit.
EP6	Error reportEligibility & health card	Health Number (HN) Not Activated	The health number isn't activated - have the patient activate it with ServiceOntario, then resubmit once it's active.
EP7	Error reportService, fee & diagnosis	Code must be billed alone	This code must be billed on its own - remove the other codes from the claim and submit it alone.
EQ1	Error reportReferral & provider	Clinic/Doctor Not on File - Practitioner not registered with OHIP	The practitioner isn't registered with OHIP / on file - register (or correct the billing number) with the Ministry, then resubmit.
EQ2	Error reportReferral & provider	Specialty mismatch – Specialty Code is inactive or not registered on date of service	Use a specialty code that's active and registered for you on the service date, then resubmit.
EQ3	Error reportReferral & provider	Claim submitted as Pay Patient - Health care provider is registered as OPTED-IN for date of service	You're opted-in for this date - resubmit the claim as Pay Provider rather than Pay Patient.
EQ4	Error reportReferral & provider	Claim submitted as Pay Provider - Health care provider is registered as OPTED-OUT for date of service	You're opted-out for this date - resubmit the claim as Pay Patient rather than Pay Provider.
EQ5	Error reportReferral & provider	Lab inactive on Service date	The lab is inactive for the service date - confirm the lab's active registration with the Ministry, then resubmit.
EQ6	Error reportReferral & provider	Incorrect Referral Number - Referring/requisitioning health care provider number is not registered with the Ministry of Health	The referring/requisitioning provider's number isn't registered with the Ministry - correct it to a registered provider's number and resubmit.
EQ9	Error reportReferral & provider	Lab Number not on File	The lab number isn't on the Ministry's file - correct it and resubmit.
EQB	Error reportReferral & provider	Solo practitioner inactive on service date Practitioner number is Midwife (700000-722899) referral only Claims submitted by Chiropractors using their Claim Submission Number (CSN) Physician Registered as group billing only	The solo billing number is inactive or referral-only for the service date (e.g. midwife referral-only, chiropractor CSN, or a physician registered for group billing only) - bill under the correct active number, then resubmit.
EQC	Error reportReferral & provider	Group not registered	Register the group with the Ministry (or correct the group number), then resubmit.
EQD	Error reportReferral & provider	Group inactive on service date	The group is inactive for the service date - confirm its active registration with the Ministry, then resubmit.
EQE	Error reportReferral & provider	Affiliated Practitioner not in Group - Health care provider is not registered with the Ministry of Health as an affiliate of this group on date of service	You aren't registered as an affiliate of this group on the service date - add the group affiliation with the Ministry, then resubmit.
EQF	Error reportReferral & provider	Affiliated Practitioner inactive - Health care provider is not actively registered with the Ministry of Health as an affiliate of this group on date of service	Your affiliation with this group is inactive for the service date - reactivate or confirm it with the Ministry, then resubmit.
EQG	Error reportReferral & provider	Referring laboratory is not registered with the Ministry of Health	The referring laboratory isn't registered with the Ministry - correct it to a registered lab number and resubmit.
EQI	Error reportService, fee & diagnosis	Contract characteristics error	There is a mismatch with your group's contract or agreement setup. Confirm the contract characteristics registered with the Ministry for the service date, then resubmit.
EQJ	Error reportReferral & provider	Practitioner Not Eligible On Service Date - New Graduate bills New Patient fee (Q013) or Physician (not a new graduate) bills new Graduate-New Patient fee (Q033).	Use the new-patient fee that matches your status - Q013 if you're not a new graduate, Q033 if you are - then resubmit.
EQK	Error reportReferral & provider	Master Number (MNI) Does not Meet Criteria - A100 billed with a specialty code other than 00.	A100 can only be billed under specialty 00 - bill the appropriate code for your specialty instead, then resubmit.
EQL	Error reportReferral & provider	Physician Not Eligible to Claim FSC - A100 billed with a speciality code other than 00 or billed by provider with any Emergency Department Alternate Funding arrangement (EDAFA) group number.	You can't claim A100 under your specialty (non-00) or EDAFA group arrangement - bill the appropriate assessment code instead, then resubmit.
EQM	Error reportReferral & provider	Not Registered for Use	This code/service isn't registered for your use - register with the Ministry or use a code you're approved for, then resubmit.
EQN	Error reportService, fee & diagnosis	Registration Usage Error on Service Date	Your registration doesn't permit this code/use on the service date - confirm your registration covers it, then resubmit.
EQP	Error reportEligibility & health card	Enrolment Type Not Eligible	The patient's enrolment type isn't eligible for this code - bill the code that fits their enrolment type, then resubmit.
EQS	Error reportReferral & provider	Practitioner Criteria Not Met	You don't meet the practitioner criteria required for this code - confirm the eligibility criteria with the Ministry before resubmitting.
ERF	Error reportReferral & provider	Referring physician number is currently ineligible for referrals	The referring physician's number is currently ineligible to refer - use an eligible referring provider's number, then resubmit.
ESD	Error reportReferral & provider	APP group affiliation on service date - Hospital Emergency Department is part of an alternative funding agreement	This Emergency Department is under an Alternate Funding (APP) agreement for the service date - bill through the AFA arrangement instead of fee-for-service.
ESF	Error reportService, fee & diagnosis	Not eligible to bill	You aren't eligible to bill this service - confirm your registration and criteria for the service date before resubmitting.
ESH	Error reportService, fee & diagnosis	Not Eligible For Blank HN	This service can't be billed without a health number - add the patient's health number and resubmit.
ESN	Error reportService, fee & diagnosis	Invalid Blank HN Claim - No HN required for FSC	This fee code doesn't take a health number - remove the health number from the claim and resubmit.
HCC	Error reportReferral & provider	Not on Health Care Connect (HCC) database-Not Eligible On HCC database but not Complex-Vulnerable On HCC database but not in 'referred to' status	The patient isn't in a 'referred to' status on the Health Care Connect (HCC) database for this code - confirm their HCC status before billing the HCC fee.
HCE	Error reportReferral & provider	Patient enrolled to billing physician but later than 3 months from the "referred to" date on HCC database-Enrolment after 3 Months	The patient was enrolled more than 3 months after the Health Care Connect 'referred to' date - the HCC bonus doesn't apply; bill the standard enrolment code instead.
PAA	Error reportService, fee & diagnosis	No Initial Fee Previously Paid - To ensure the smoking cessation initial discussion fee (E079) has been paid within 365 days prior to the smoking cessation counseling fee (Q042) or the smoking cessation follow up fee (K039)	The smoking-cessation counselling (Q042) or follow-up (K039) requires the initial discussion fee (E079) to have been paid within the previous 365 days. Confirm E079 was billed and paid first, and bill it if it was missed.
PA1	Error reportService, fee & diagnosis	Invalid PA Service - Physician Assistant (PA) Pilot claim submissions may contain one or more PA Tracking FSC's but other OHIP insured service FSCs are not allowed on the same claim.	Submit the PA (Physician Assistant) Pilot tracking codes on their own claim - remove the other OHIP service codes from this claim - then resubmit.
PA2	Error reportReferral & provider	Invalid PA Claim - Physician Assistant Pilot (PA) claim submissions with the PA as the submitting physician must identify the solo billing number of the supervising physician in the "Refer Physician" field.	Add the supervising physician's solo billing number in the 'Referring Physician' field of the PA Pilot claim, then resubmit.
PA3	Error reportReferral & provider	Not registered for PA - The physician and/or referring physician fields on the PA Pilot claim submission contain billing numbers which are not affiliated to the PA Pilot group number.	The physician and/or referring-physician numbers on the PA Pilot claim aren't affiliated with the PA Pilot group - correct them to affiliated numbers and resubmit.
PA4	Error reportService, fee & diagnosis	PA Registration on Service Date Error	Confirm the Physician Assistant was registered for the PA Pilot on the service date, correct the registration or date, and resubmit.
PA5	Error reportService, fee & diagnosis	PA Affiliation Error	Correct the Physician Assistant Pilot affiliation on the claim (the PA-to-physician affiliation is wrong), then resubmit.
PA6	Error reportService, fee & diagnosis	PA Affiliation on Service Date Error	Confirm the PA Pilot affiliation was valid on the service date, correct it, then resubmit.
V02	Error reportService, fee & diagnosis	Invalid Region Code	Correct the region code on the claim and resubmit.
V05	Error reportService, fee & diagnosis	Error-Claim Number is less than Service Date	The claim/accounting number is earlier than the service date - correct the claim number or the service date so they're consistent, then resubmit.
V06	Error reportService, fee & diagnosis	Incorrect Clinic Code	Correct the clinic / group number on the claim and resubmit.
V07	Error reportReferral & provider	Invalid Practitioner Number	Correct the practitioner (billing) number and resubmit.
V08	Error reportReferral & provider	Invalid Specialty Code: • Specialty code is missing/not 2 numerics • Not a valid specialty code • Specialty code is 27 and provider number is not 599993 • Specialty code is 90 and provider number is not 991000 • Specialty code is 49, 50, 51, 52, 53, 54, 55, 70 and 71 and the health care provider number does not begin with 4 • Specialty code is 56 and health care provider number does not begin with 80 or 81 • Specialty code is 80 or 81 and health care provider number does not begin with 82	Correct the specialty code - it must be a valid 2-digit code consistent with your provider number - then resubmit.
V09	Error reportReferral & provider	Invalid Referral Number	Correct the referral number to a valid referring provider's billing number and resubmit.
V13	Error reportService, fee & diagnosis	Patient's date of birth is missing/invalid format Month not in the range of 01-12 Not 8 numerics Day is outside acceptable range for month	Enter the patient's date of birth in the correct format - 8 digits, month 01-12 and a valid day - then resubmit.
V16	Error reportService, fee & diagnosis	Unacceptable Diagnostic Code Not numeric	The diagnostic code must be numeric - enter a valid 3-digit numeric OHIP diagnostic code and resubmit.
V17	Error reportService, fee & diagnosis	Payee must be 'P' (Provider) or 'S' (Patient)	Set the payee field to 'P' (pay provider) or 'S' (pay patient) and resubmit.
V18	Error reportService, fee & diagnosis	Invalid Admission/First Visit date	Correct the admission / first-visit date and resubmit.
V19	Error reportReferral & provider	Invalid Chiropractor Diagnostic Code	Use a valid chiropractic diagnostic code and resubmit.
V20	Error reportService, fee & diagnosis	Unacceptable Age for Diagnostic code - Service code is A007, patient is over 2 years old and diagnostic code is '916' or service code is A003 and the patient is under 16 years old and the diagnostic code is '917'	The diagnostic code doesn't fit the patient's age for this service (A007 vs A003, dx 916 vs 917) - use the age-appropriate diagnostic code and resubmit.
V21	Error reportService, fee & diagnosis	Diagnostic Code Required	Add the correct 3-digit OHIP diagnostic code (look it up in the OHIP Diagnostic Codes tool) and resubmit.
V22	Error reportService, fee & diagnosis	Invalid Diagnostic Code	Replace it with a valid 3-digit OHIP diagnostic code (look it up in the OHIP Diagnostic Codes tool) and resubmit.
V23	Error reportService, fee & diagnosis	Check Number Of Services	Check and correct the number of services on the claim line, then resubmit.
V28	Error reportService, fee & diagnosis	Invalid Hospital Number	Correct the hospital number on the claim and resubmit.
V29	Error reportService, fee & diagnosis	Invalid In-Out-Patient Indicator	Set the in-patient / out-patient indicator correctly for the service and resubmit.
V30	Error reportService, fee & diagnosis	FSC/Diagnostic Code Combination Not A Benefit (NAB)	This fee code and diagnostic code combination isn't a benefit - change the diagnostic code (or the service code) so the combination is payable, then resubmit.
V31	Error reportReferral & provider	Error in Claim Header - Missing any of the following: group number, health care provider number, specialty code	Complete the claim header - add the missing group number, health care provider number, or specialty code - then resubmit.
V34	Error reportService, fee & diagnosis	Invalid Service Code Service Code and Health Care provider type mismatch	The service code isn't valid for your provider type - use a code your provider type can bill, then resubmit.
V35	Error reportService, fee & diagnosis	Invalid Out-of-Province/Out-of-Country Service	Correct the out-of-province / out-of-country service details, or bill the patient's home province, then resubmit.
V36	Error reportService, fee & diagnosis	Check input criteria required for sessional billing	Complete the fields required for sessional billing (sessional code and times / units as applicable), then resubmit.
V39	Error reportService, fee & diagnosis	Number of items exceeds the maximum (99)	The claim has more than 99 items - split it into claims of 99 items or fewer, then resubmit.
V40	Error reportService, fee & diagnosis	Invalid Fee Schedule Code Service code is missing Service code is not in the format ANNNA where: • A is alphabetic (A-Z) • NNN is numeric (001-999) • A is alphabetic (A-C)	Correct the fee schedule code to the valid ANNNA format (a letter, then 001-999, then a letter A-C) and resubmit.
V41	Error reportService, fee & diagnosis	Invalid Fee Billed Fee submitted is missing/not 6 numerics Fee submitted is not in the range '000000'-'500000' ($$$$cc)	Enter the fee as 6 digits within the $0000.00-$5000.00 range, then resubmit.
V42	Error reportService, fee & diagnosis	Invalid Number of Services Number of services is missing/not 2 numerics Number of services is not in the range '01-99'	Enter the number of services as 2 digits in the range 01-99, then resubmit.
V47	Error reportService, fee & diagnosis	Fee not Divisible - Fee submitted is not evenly divisible (to the cent) by the number of services	Adjust the fee so it divides evenly (to the cent) by the number of services, then resubmit.
V50	Error reportService, fee & diagnosis	Service Date Pre Initial Visit - Physiotherapy	The physiotherapy service date is before the initial visit - correct the date so it's on or after the initial visit, then resubmit.
V51	Error reportService, fee & diagnosis	Invalid location code - must be blank or four numerics. If present, must be valid based on MOHLTC Residency Code Manual	Set the location code to blank or a valid 4-digit code (per the MOHLTC Residency Code Manual), then resubmit.
V53	Error reportService, fee & diagnosis	Invalid FSC-Magnetic Tape/Disk	Correct the fee schedule code (it's invalid for this submission) and resubmit.
V62	Error reportReferral & provider	Invalid service location indicator - hospital diagnostic service billing from a participating hospital physician/group is not of the five valid SLI codes (HDS, HED, HIP, HOP or HRP)	Use one of the five valid service location indicators - HDS, HED, HIP, HOP, or HRP - and resubmit.
V63	Error reportReferral & provider	Referring Laboratory Number must start with 5 (5###)	Correct the referring laboratory number so it starts with 5 (5###), then resubmit.
V64	Error reportService, fee & diagnosis	Missing service location indicator	Add the service location indicator (SLI) to the claim and resubmit.
V65	Error reportService, fee & diagnosis	Missing master number - SLI code HDS, HED, HIP, HOP or HRP is included with a diagnostic service billing but a master number was not included	Add the master number (identifying the facility) to the SLI diagnostic-service claim and resubmit.
V66	Error reportService, fee & diagnosis	Missing admission date - SLI code HIP is included with a diagnostic service billing but an admission date was not included	Add the admission date to the HIP service-location claim and resubmit.
V67	Error reportService, fee & diagnosis	Missing master number and admission date - assigned when a SLI code HIP is included with a diagnostic service billing but a master number and admission date were both not included	Add both the master number and the admission date to the HIP diagnostic-service claim and resubmit.
V68	Error reportService, fee & diagnosis	Incorrect service location indicator - assigned when a diagnostic service is billed with a master number and admission date but the SLI code is not HIP	When billing with a master number and admission date, set the service location indicator to HIP, then resubmit.
V69	Error reportService, fee & diagnosis	Service Date Invalid for SLI	Correct the service date so it's valid for the service location indicator used, then resubmit.
V70	Error reportService, fee & diagnosis	Date of service is greater than the file/batch creation date	The service date is after the file/batch creation date - correct it (it can't be in the future) and resubmit.
V71	Error reportService, fee & diagnosis	Invalid Dental Master Number	Correct the dental master number on the claim and resubmit.
V73	Error reportService, fee & diagnosis	OTN SLI No Longer Active	The OTN service-location indicator is no longer active. Use the current virtual-care venue / SLI code for this service and resubmit.
V98	Error reportService, fee & diagnosis	Wrong Preventive Care Date of Service	Correct the preventive-care service date - it must fall within the interval allowed for the preventive code - then resubmit.
VJ5	Error reportService, fee & diagnosis	Invalid Service Date Date of Service is missing/not 8 numerics Month is not in the range 01-12 Day is outside acceptable range for month Date of Service is greater than Ministry of Health system run date	Enter a valid service date - 8 digits, month 01-12, a valid day, and not after the Ministry's run date - then resubmit.
VJ7	Error reportService, fee & diagnosis	Stale-dated Claim	The claim is past the six-month stale-dating deadline, so a normal resubmission won't pay. Submit a stale-dated claim request to the Ministry with justification if you have grounds.
VJ8	Error reportService, fee & diagnosis	Stale-dated Claim Encounter	The encounter claim is stale-dated (past the submission deadline). Resubmitting won't pay; request a stale-dated review from the Ministry if eligible.
VHC	Error reportEligibility & health card	SLI required for technical fee	Add the service location indicator (SLI) required for the technical fee, then resubmit.
VS1	Error reportService, fee & diagnosis	Invalid SEAMO Provider Code	Correct the SEAMO provider code and resubmit.
VS2	Error reportService, fee & diagnosis	Invalid Venue Type	Set a valid venue type for the service and resubmit.
VS3	Error reportService, fee & diagnosis	Invalid Clinic Number	Correct the clinic number and resubmit.
VS4	Error reportService, fee & diagnosis	Invalid Healthcare Item	Use a valid healthcare item code and resubmit.
VS5	Error reportService, fee & diagnosis	Invalid In-Patient/Out-Patient Indicator	Set the in-patient / out-patient indicator correctly for the service and resubmit.
VS6	Error reportService, fee & diagnosis	Invalid HC Item Code Format	Correct the healthcare item code format and resubmit.
VTC	Error reportService, fee & diagnosis	Virtual Tech Code required	Add the required Virtual Tech Code (VTC) to the claim and resubmit.
VT1	Error reportService, fee & diagnosis	Only 1 VTC allowed	Only one Virtual Tech Code is allowed per claim - remove the extra VTC and resubmit.
VHA	Error reportEligibility & health card	OHIP number not registered with ministry for health number	The OHIP registration number isn't registered to this health number - correct the health number or registration number so they match, then resubmit.
VHB	Error reportEligibility & health card	No HN Required for FSC A non-encounter service claim submitted with a Health Number	This non-encounter service should not include a health number - remove the health number from the claim and resubmit.
VH0	Error reportEligibility & health card	Header 2 and HN Present Claim Header-2 present on MRI claim submitted with Health Number in Claim Header-1	On this MRI claim the headers conflict - remove the extra Claim Header-2 (or the health number in Header-1) so only one is present, then resubmit.
VH1	Error reportEligibility & health card	Health Number is missing/invalid	Re-read all 10 digits off the card, correct the health number, and resubmit.
VH2	Error reportEligibility & health card	Health Number is Missing Health Number is not present (Payment program is HCP or WCB)	Add the patient's health number (required for HCP and WCB claims) and resubmit.
VH3	Error reportEligibility & health card	Invalid Payment Program The payment program is missing or is not equal to HCP, RMB, WCB	Set a valid payment program - HCP for OHIP, RMB for reciprocal / out-of-province, or WCB for workplace claims - and resubmit.
VH4	Error reportEligibility & health card	Invalid Version Code	Correct the health-card version code (the two letters after the number) and resubmit.
VH5	Error reportEligibility & health card	OHIP Number Required for Service Date	Add the patient's OHIP (health) number for the service date and resubmit.
VH6	Error reportEligibility & health card	Mixed Service Dates	Split the claim so each one covers a single service date (this claim mixes dates that can't be combined), then resubmit.
VH7	Error reportEligibility & health card	Health number and OHIP number on same claim	Use only one identifier - remove either the health number or the OHIP registration number so they don't conflict - and resubmit.
VH8	Error reportEligibility & health card	Date of birth does not match the Health Number submitted	Confirm the patient's date of birth (from the card, or the Ministry's IVR line at 416-326-6666), correct it, and resubmit.
VH9	Error reportEligibility & health card	Health Number is not registered with ministry	Wait until the patient receives their health card, update the number, then resubmit within the stale-dating window.
EF1	Error reportProgram-specific	ICHSC number not approved for billing on the date specified	The ICHSC number isn't approved to bill on that date - confirm the centre's approval for the service date with the Ministry, then resubmit.
EF2	Error reportProgram-specific	ICHSC not licensed or grandfathered to bill FSC on the date specified	The ICHSC isn't licensed or grandfathered to bill this fee code on that date - use an eligible code or confirm licensing, then resubmit.
EF3	Error reportProgram-specific	Insured services are excluded from ICHSC billings	Insured services can't be billed through the ICHSC - bill the insured service through OHIP instead.
EF4	Error reportProgram-specific	Provider is not approved to bill ICHSC fee on date specified	You aren't approved to bill this ICHSC fee on the service date - confirm your approval with the Ministry, then resubmit.
EF5	Error reportProgram-specific	ICHSC practitioner 991000 is not allowed to bill insured services	Practitioner number 991000 can't bill insured services - bill insured services under the correct provider number, then resubmit.
EF7	Error reportProgram-specific	Referring physician number is required for the ICHSC fee billed	Add the required referring physician number for this ICHSC fee, then resubmit.
EF8	Error reportProgram-specific	'I' service codes are exclusive to ICHSCs	'I' service codes can only be billed by an ICHSC - use the appropriate non-'I' code, then resubmit.
EF9	Error reportProgram-specific	Mobile site number required	Add the required mobile site number to the claim and resubmit.
R01	Error reportProgram-specific	Missing Health Service Number (HSN)	Add the out-of-province patient's Health Service Number (HSN) to the reciprocal claim and resubmit.
R02	Error reportProgram-specific	Invalid HSN	Correct the out-of-province Health Service Number (HSN) and resubmit.
R03	Error reportProgram-specific	Invalid/Missing Province Code	Add or correct the patient's province code on the reciprocal claim and resubmit.
R04	Error reportProgram-specific	Service Excluded from RMBS	This service is excluded from reciprocal medical billing - bill the patient's home province (or the patient) directly.
R05	Error reportProgram-specific	Provincial code invalid for RMBS Province code of 'ON' (Ontario) or ‘PQ’ (Quebec) and not an Outaouais claim	Reciprocal billing can't use 'ON', and 'PQ' only for Outaouais claims - correct the province code, or bill RAMQ for Quebec patients, then resubmit.
R06	Error reportProgram-specific	Invalid Provider for RMBS	You aren't a valid provider for reciprocal billing - confirm your registration, or bill the patient's home province, then resubmit.
R07	Error reportProgram-specific	Invalid Payment Type for RMBS	Correct the payment type for the reciprocal claim and resubmit.
R08	Error reportProgram-specific	Invalid Referral Number	Correct the referral number on the reciprocal claim to a valid referring provider's number and resubmit.
R09	Error reportProgram-specific	Claim Header 2 Missing-RMB	Add the required Claim Header-2 for the reciprocal (RMB) claim and resubmit.
V10	Error reportService, fee & diagnosis	Patient's last name is missing/not alphabetic (A-Z) First field position is blank	Enter the patient's last name (letters A-Z, with the first position filled) and resubmit.
V12	Error reportService, fee & diagnosis	Patient's first name is missing/not alphabetic (A-Z) First field position is blank	Enter the patient's first name (letters A-Z, with the first position filled) and resubmit.
V14	Error reportService, fee & diagnosis	Patient sex must be '1' (male) or '2' (female)	Set the patient's sex to '1' (male) or '2' (female) and resubmit.
ET1	Error reportProgram-specific	Not Registered for Telemedicine	Register for the Telemedicine / virtual-care program with the Ministry, then resubmit.
ET4	Error reportProgram-specific	Telemedicine Premium/Tracking Code Missing	Add the required telemedicine premium / tracking code to the claim and resubmit.
ET5	Error reportProgram-specific	Telemedicine SLI Missing/Invalid - The telemedicine billing is submitted with a telemedicine tracking code but the SLI code is not 'OTN' or is not present.	Add the 'OTN' service location indicator to the telemedicine claim (the tracking code requires it), then resubmit.
TM1	Error reportProgram-specific	Duplicate Telemedicine Claim, Same patient	A telemedicine claim was already submitted for this patient and date - remove the duplicate.
TM2	Error reportProgram-specific	Service not Billable for Missed/ Cancelled/Abandoned Appointment	Missed, cancelled, or abandoned appointments aren't billable - remove this claim.
TM3	Error reportProgram-specific	Service not payable underTelemedicine Program	This service isn't payable under the Telemedicine Program - bill it as a regular service if eligible, otherwise remove it.
TM4	Error reportProgram-specific	Non Telemedicine Claim paid for same patient	A non-telemedicine claim was already paid for this patient and date - confirm whether both are payable; file a Remittance Advice Inquiry if the telemedicine service was separate.
TM5	Error reportProgram-specific	Telemedicine Claim Paid for same patient	A telemedicine claim was already paid for this patient and date - don't rebill; file a Remittance Advice Inquiry if a separate service was missed.
TM6	Error reportProgram-specific	Registration not in effect on Service Date	Your telemedicine registration wasn't in effect on the service date - confirm or backdate your registration with the Ministry, then resubmit.
TM7	Error reportProgram-specific	Dental Service not eligible for Telemedicine	Dental services aren't eligible for telemedicine - bill it through the appropriate program instead.
TM8	Error reportProgram-specific	Not eligible for Store Forward	This service isn't eligible for Store-and-Forward telemedicine - use the correct telemedicine code/modality, then resubmit.
VW1	Error reportProgram-specific	Invalid WCB Service	Submit this through the WSIB/WCB program rather than OHIP, with the correct WCB details.
09	Remittance AdvicePayment-time (remittance)	Fee Schedule Code(s) used is not correct, please resubmit claim with the appropriate FSC or submit an RAI if the claim is posted on a Remittance Advice	Resubmit the claim as the reason indicates (for example with the correct fee schedule code), or file a Remittance Advice Inquiry if it was already billed correctly.
30	Remittance AdvicePayment-time (remittance)	Service is not a benefit of OHIP (Ontario Health Insurance Plan)	Not payable by OHIP under this rule - bill the patient or the correct payer if the service is uninsured, or file a Remittance Advice Inquiry if you believe it qualifies.
31	Remittance AdvicePayment-time (remittance)	Not a valid network service	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
32	Remittance AdvicePayment-time (remittance)	OHIP records show service(s) on this day claimed previously	OHIP shows this was already paid - confirm it is not a true duplicate; file a Remittance Advice Inquiry with detail if the service was genuinely separate.
33	Remittance AdvicePayment-time (remittance)	Approved	Informational - the claim was paid (sometimes at an adjusted amount). No action needed unless the amount looks wrong, in which case file a Remittance Advice Inquiry.
35	Remittance AdvicePayment-time (remittance)	OHIP records show this service rendered has been claimed previously (used on Pay Practitioner duplicate claims)	OHIP shows this was already paid - confirm it is not a true duplicate; file a Remittance Advice Inquiry with detail if the service was genuinely separate.
36	Remittance AdvicePayment-time (remittance)	OHIP records show service has been rendered by another Practitioner, Group, Lab	If you provided or assessed the patient first, file a Remittance Advice Inquiry with supporting documentation.
37	Remittance AdvicePayment-time (remittance)	Effective April 1, 1993 the listed benefit for this code is 0 Laboratory Medicine Services (LMS) units	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
40	Remittance AdvicePayment-time (remittance)	Service or related service allowed only once for same patient	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
41	Remittance AdvicePayment-time (remittance)	Fee Schedule Code (FSC) Billed - No Evidence in Supporting Documentation Provided	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
42	Remittance AdvicePayment-time (remittance)	FSC Billed Included in Other Procedure	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
45	Remittance AdvicePayment-time (remittance)	Specialty code restriction on Fee Schedule Code	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
46	Remittance AdvicePayment-time (remittance)	Paid Per 2nd Review by Medical Advisor (MA)	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
47	Remittance AdvicePayment-time (remittance)	Not Paid Per 2nd Review by Medical Advisor (MA)	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
48	Remittance AdvicePayment-time (remittance)	Paid as submitted - clinical records may be requested for verification purposes	Informational - the claim was paid (sometimes at an adjusted amount). No action needed unless the amount looks wrong, in which case file a Remittance Advice Inquiry.
49	Remittance AdvicePayment-time (remittance)	Paid according to the average fee for this service. Independent consideration will be given if clinical records/operative reports presented.	Informational - the claim was paid (sometimes at an adjusted amount). No action needed unless the amount looks wrong, in which case file a Remittance Advice Inquiry.
50	Remittance AdvicePayment-time (remittance)	Paid in accordance with the Schedule of Benefits	Informational - the claim was paid (sometimes at an adjusted amount). No action needed unless the amount looks wrong, in which case file a Remittance Advice Inquiry.
51	Remittance AdvicePayment-time (remittance)	Fee Schedule Code changed in accordance with Schedule of Benefits	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
52	Remittance AdvicePayment-time (remittance)	Fee-for-service assessed by medical consultant	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
53	Remittance AdvicePayment-time (remittance)	Fee allowed according to appropriate item in a previous Schedule of Benefits	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
54	Remittance AdvicePayment-time (remittance)	Interim payment - claim under review	The claim is under review or records may be requested - keep your documentation ready; no resubmission is needed.
55	Remittance AdvicePayment-time (remittance)	Deduction is an adjustment on an earlier account	This is part of a reassessment of an earlier claim. Match the deduction and payment lines (they often net to zero); investigate the original claim if there is a real change.
56	Remittance AdvicePayment-time (remittance)	Claim under review	The claim is under review or records may be requested - keep your documentation ready; no resubmission is needed.
57	Remittance AdvicePayment-time (remittance)	This payment is an adjustment on an earlier account	This is part of a reassessment of an earlier claim. Match the deduction and payment lines (they often net to zero); investigate the original claim if there is a real change.
58	Remittance AdvicePayment-time (remittance)	Claimed by another physician within group	If you provided or assessed the patient first, file a Remittance Advice Inquiry with supporting documentation.
59	Remittance AdvicePayment-time (remittance)	Practitioner's notification - WCB claims	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
60	Remittance AdvicePayment-time (remittance)	Not a benefit of the Reciprocal Medical Billing Agreement	Not payable by OHIP under this rule - bill the patient or the correct payer if the service is uninsured, or file a Remittance Advice Inquiry if you believe it qualifies.
62	Remittance AdvicePayment-time (remittance)	Claim assessed by Assessment Officer	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
65	Remittance AdvicePayment-time (remittance)	Service included in approved hospital payment	Informational - the claim was paid (sometimes at an adjusted amount). No action needed unless the amount looks wrong, in which case file a Remittance Advice Inquiry.
66	Remittance AdvicePayment-time (remittance)	Reduced per Alternative Payment Program (APP) Funding Contract	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
69	Remittance AdvicePayment-time (remittance)	Elective Services Paid At 75% Of OHIP Schedule of Rates	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
70	Remittance AdvicePayment-time (remittance)	OHIP records show corresponding procedure(s) on this day claimed previously by another physician	OHIP shows this was already paid - confirm it is not a true duplicate; file a Remittance Advice Inquiry with detail if the service was genuinely separate.
80	Remittance AdvicePayment-time (remittance)	Technical fee adjustment for hospitals	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
AP	Remittance AdvicePayment-time (remittance)	This payment is in accordance with legislation. If you disagree with the payment, you may appeal to the General Manager	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
AH	Remittance AdvicePayment-time (remittance)	Not allowed in addition to health exam	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
B1	Remittance AdvicePayment-time (remittance)	Service Not Eligible for Payment When Delivered by Telephone Paid in accordance with the OHIP Schedule of Benefits for Telephone	Informational - the claim was paid (sometimes at an adjusted amount). No action needed unless the amount looks wrong, in which case file a Remittance Advice Inquiry.
B2	Remittance AdvicePayment-time (remittance)	Virtual Care Services	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
B3	Remittance AdvicePayment-time (remittance)	Patient-Physician Relationship Requirements Not Met	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
B4	Remittance AdvicePayment-time (remittance)	Virtual Service not allowed in addition to In-Person Equivalent Service In-Person Service Not Allowed in Addition to Virtual Equivalent	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
B5	Remittance AdvicePayment-time (remittance)	Service	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
B6	Remittance AdvicePayment-time (remittance)	Limited Virtual Care Service Already Paid	OHIP shows this was already paid - confirm it is not a true duplicate; file a Remittance Advice Inquiry with detail if the service was genuinely separate.
B7	Remittance AdvicePayment-time (remittance)	Comprehensive Virtual Care Service Already Paid	OHIP shows this was already paid - confirm it is not a true duplicate; file a Remittance Advice Inquiry with detail if the service was genuinely separate.
B8	Remittance AdvicePayment-time (remittance)	Service Not Eligible for Payment Virtually	Not payable by OHIP under this rule - bill the patient or the correct payer if the service is uninsured, or file a Remittance Advice Inquiry if you believe it qualifies.
C1	Remittance AdvicePayment-time (remittance)	Allowed as repeat/limited consultation/midwife-requested emergency assessment	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
C2	Remittance AdvicePayment-time (remittance)	Allowed at re-assessment fee	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
C3	Remittance AdvicePayment-time (remittance)	Allowed at minor assessment fee	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
C4	Remittance AdvicePayment-time (remittance)	Consultation not allowed with this service-paid as assessment	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
C5	Remittance AdvicePayment-time (remittance)	Allowed as multiple systems assessment	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
C6	Remittance AdvicePayment-time (remittance)	Allowed as Type 2 admission assessment	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
C7	Remittance AdvicePayment-time (remittance)	An admission assessment (C003A) or general re-assessment (C004A) may not be claimed by any physician within 30 days following a pre- dental/pre-operative assessment	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
C8	Remittance AdvicePayment-time (remittance)	Payment reduced to geriatric consultation fee-maximum number of comprehensive geriatric consultations has been reached	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
C9	Remittance AdvicePayment-time (remittance)	Allowed as in-patient interim admission orders-initial assessment already claimed by other physician	OHIP shows this was already paid - confirm it is not a true duplicate; file a Remittance Advice Inquiry with detail if the service was genuinely separate.
D1	Remittance AdvicePayment-time (remittance)	Allowed as repeat procedure-initial procedure previously claimed	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
D2	Remittance AdvicePayment-time (remittance)	Additional procedures allowed at 50%	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
D3	Remittance AdvicePayment-time (remittance)	Not allowed in addition to visit fee	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
D4	Remittance AdvicePayment-time (remittance)	Procedure allowed at 50% with visit	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
D5	Remittance AdvicePayment-time (remittance)	Procedure already allowed-visit fee adjusted	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
D6	Remittance AdvicePayment-time (remittance)	Limit of payment for this procedure reached	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
D7	Remittance AdvicePayment-time (remittance)	Not allowed in addition to other procedure	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
D8	Remittance AdvicePayment-time (remittance)	Allowed with specific procedures only	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
D9	Remittance AdvicePayment-time (remittance)	Not allowed to a hospital department	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
DA	Remittance AdvicePayment-time (remittance)	Maximum for this procedure reached - paid as repeat/chronic procedure	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
DB	Remittance AdvicePayment-time (remittance)	Other dialysis procedure already paid	OHIP shows this was already paid - confirm it is not a true duplicate; file a Remittance Advice Inquiry with detail if the service was genuinely separate.
DC	Remittance AdvicePayment-time (remittance)	Procedure paid previously not allowed in addition to this procedure- fee adjusted to pay the difference	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
DD	Remittance AdvicePayment-time (remittance)	Not allowed as diagnostic code is unrelated to original eye exam	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
DE	Remittance AdvicePayment-time (remittance)	Lab tests already paid-visit fee adjusted	OHIP shows this was already paid - confirm it is not a true duplicate; file a Remittance Advice Inquiry with detail if the service was genuinely separate.
DF	Remittance AdvicePayment-time (remittance)	Corresponding fee code was not billed or paid at zero	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
DG	Remittance AdvicePayment-time (remittance)	Diagnostic/Miscellaneous services for hospital patients are not payable on a fee-for-service basis in the Hospital Global budget.	Not payable by OHIP under this rule - bill the patient or the correct payer if the service is uninsured, or file a Remittance Advice Inquiry if you believe it qualifies.
DH	Remittance AdvicePayment-time (remittance)	Ventilatory support allowed with Haemodialysis	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
DL	Remittance AdvicePayment-time (remittance)	Allowed as laboratory tests in private office	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
DM	Remittance AdvicePayment-time (remittance)	Paid/disallowed in accordance with MOH policy regarding an Emergency Department Equivalent	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
DN	Remittance AdvicePayment-time (remittance)	Allowed as pudenal block in addition to procedure-as per stated OHIP policy	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
DP	Remittance AdvicePayment-time (remittance)	Procedure paid previously allowed at 50% in addition to this procedure-fee adjusted to pay the difference	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
DS	Remittance AdvicePayment-time (remittance)	Not allowed-mutually exclusive code billed	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
DT	Remittance AdvicePayment-time (remittance)	In-patient technical fee not allowed	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
DR	Remittance AdvicePayment-time (remittance)	Self-Referred Diagnostic Services Payable at 50%	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
DV	Remittance AdvicePayment-time (remittance)	Service is included in Monthly Management Fee for Long-Term Care (LTC) patients	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
DW	Remittance AdvicePayment-time (remittance)	Procedure paid previously not allowed in addition to monthly management. For long-term care patients-fee adjusted to pay the difference.	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
DX	Remittance AdvicePayment-time (remittance)	Diagnostic code not eligible with Fee Schedule Code	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
E1	Remittance AdvicePayment-time (remittance)	Service date prior to start of eligibility	Check the patient eligibility and health card for the service date. If they were covered, file a Remittance Advice Inquiry; otherwise bill the correct payer.
E2	Remittance AdvicePayment-time (remittance)	Incorrect version code for service date	Check the patient eligibility and health card for the service date. If they were covered, file a Remittance Advice Inquiry; otherwise bill the correct payer.
E3	Remittance AdvicePayment-time (remittance)	Version Code not on File for HN (Health Number)	Check the patient eligibility and health card for the service date. If they were covered, file a Remittance Advice Inquiry; otherwise bill the correct payer.
E4	Remittance AdvicePayment-time (remittance)	Service date after the eligibility termination date	Check the patient eligibility and health card for the service date. If they were covered, file a Remittance Advice Inquiry; otherwise bill the correct payer.
E5	Remittance AdvicePayment-time (remittance)	Service date not within an eligible period	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
E6	Remittance AdvicePayment-time (remittance)	Service Date after Eligibility End Date - Eligibility Terminated as MOH Records Indicate Patient Deceased	Check the patient eligibility and health card for the service date. If they were covered, file a Remittance Advice Inquiry; otherwise bill the correct payer.
E9	Remittance AdvicePayment-time (remittance)	Service Date after Eligibility End Date - Eligibility Terminated Due to no Response to Notice to Register	Check the patient eligibility and health card for the service date. If they were covered, file a Remittance Advice Inquiry; otherwise bill the correct payer.
EA	Remittance AdvicePayment-time (remittance)	Service date is not within an eligible period - Services provided on or after the 20th of this month will not be paid unless eligibility status changes	Check the patient eligibility and health card for the service date. If they were covered, file a Remittance Advice Inquiry; otherwise bill the correct payer.
EB	Remittance AdvicePayment-time (remittance)	Coding added/changed in accordance with Schedule of Benefits	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
EE	Remittance AdvicePayment-time (remittance)	Assessment Allowed at Full Fee for Patient Proceeding to Hospital	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
EF	Remittance AdvicePayment-time (remittance)	Incorrect version code-services provided on or after the 20th of this month will not be paid unless the current version code is provided	Check the patient eligibility and health card for the service date. If they were covered, file a Remittance Advice Inquiry; otherwise bill the correct payer.
EN	Remittance AdvicePayment-time (remittance)	Network billing not allowed	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
EP	Remittance AdvicePayment-time (remittance)	This payment is an adjustment of an earlier account due to provider registration update	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
EV	Remittance AdvicePayment-time (remittance)	Check health card for current version code	Check the patient eligibility and health card for the service date. If they were covered, file a Remittance Advice Inquiry; otherwise bill the correct payer.
F1	Remittance AdvicePayment-time (remittance)	Additional fractures/dislocations allowed at 85%	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
F2	Remittance AdvicePayment-time (remittance)	Allowed in accordance with transferred care	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
F3	Remittance AdvicePayment-time (remittance)	Previous attempted reductions (open or closed) allowed at 85%	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
F5	Remittance AdvicePayment-time (remittance)	Two weeks aftercare included in fracture fee	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
F6	Remittance AdvicePayment-time (remittance)	Allowed as Minor/Partial Assessment	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
FF	Remittance AdvicePayment-time (remittance)	Additional payment for the claim shown	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
G1	Remittance AdvicePayment-time (remittance)	Other critical/comprehensive care already paid	OHIP shows this was already paid - confirm it is not a true duplicate; file a Remittance Advice Inquiry with detail if the service was genuinely separate.
GF	Remittance AdvicePayment-time (remittance)	Coverage lapsed-bill patient for future claims	Check the patient eligibility and health card for the service date. If they were covered, file a Remittance Advice Inquiry; otherwise bill the correct payer.
H1	Remittance AdvicePayment-time (remittance)	Admission assessment or Emergency department assessment already paid	OHIP shows this was already paid - confirm it is not a true duplicate; file a Remittance Advice Inquiry with detail if the service was genuinely separate.
H2	Remittance AdvicePayment-time (remittance)	Allowed as subsequent visit - initial visit previously claimed	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
H3	Remittance AdvicePayment-time (remittance)	Maximum fee allowed per week after 5th week	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
H4	Remittance AdvicePayment-time (remittance)	Maximum fee allowed per week after 6th week to pediatricians	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
H5	Remittance AdvicePayment-time (remittance)	Maximum fee allowed per month after the 13th week	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
H6	Remittance AdvicePayment-time (remittance)	Allowed as supportive or concurrent care	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
H7	Remittance AdvicePayment-time (remittance)	Allowed as chronic care	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
H8	Remittance AdvicePayment-time (remittance)	Hospital number and/or admission date required for in-hospital service	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
H9	Remittance AdvicePayment-time (remittance)	Concurrent care already claimed by another doctor	OHIP shows this was already paid - confirm it is not a true duplicate; file a Remittance Advice Inquiry with detail if the service was genuinely separate.
HA	Remittance AdvicePayment-time (remittance)	Admission assessment claimed by another physician-hospital visit fee applied	If you provided or assessed the patient first, file a Remittance Advice Inquiry with supporting documentation.
HB	Remittance AdvicePayment-time (remittance)	Subsequent Visit Already Paid Same Day	OHIP shows this was already paid - confirm it is not a true duplicate; file a Remittance Advice Inquiry with detail if the service was genuinely separate.
HF	Remittance AdvicePayment-time (remittance)	Concurrent or supportive care already claimed in period	OHIP shows this was already paid - confirm it is not a true duplicate; file a Remittance Advice Inquiry with detail if the service was genuinely separate.
HM	Remittance AdvicePayment-time (remittance)	Invalid master number used on date of service	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
I2	Remittance AdvicePayment-time (remittance)	Service is globally funded	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
I3	Remittance AdvicePayment-time (remittance)	Fee Schedule Code is not on the IHF (Independent Health Facility) licence profile for the date specified	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
I4	Remittance AdvicePayment-time (remittance)	Records show service has been rendered by another Practitioner, Group or IHF	If you provided or assessed the patient first, file a Remittance Advice Inquiry with supporting documentation.
I5	Remittance AdvicePayment-time (remittance)	Service is globally funded and Fee Schedule Code is not on IHF licence profile	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
I6	Remittance AdvicePayment-time (remittance)	Premium not applicable	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
I7	Remittance AdvicePayment-time (remittance)	Claim date does not match patient enrolment date	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
I8	Remittance AdvicePayment-time (remittance)	Confirmation not received	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
I9	Remittance AdvicePayment-time (remittance)	Payment not applicable/expired	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
J1	Remittance AdvicePayment-time (remittance)	Service Date is Before the Effective Date of OHIP Coverage	Check the patient eligibility and health card for the service date. If they were covered, file a Remittance Advice Inquiry; otherwise bill the correct payer.
J2	Remittance AdvicePayment-time (remittance)	Service Date is After the Termination of Coverage Date	Check the patient eligibility and health card for the service date. If they were covered, file a Remittance Advice Inquiry; otherwise bill the correct payer.
J3	Remittance AdvicePayment-time (remittance)	Approved for stale dated processing	Informational - the claim was paid (sometimes at an adjusted amount). No action needed unless the amount looks wrong, in which case file a Remittance Advice Inquiry.
J5	Remittance AdvicePayment-time (remittance)	Coverage Applied For; Premiums Not Yet Paid	Check the patient eligibility and health card for the service date. If they were covered, file a Remittance Advice Inquiry; otherwise bill the correct payer.
J7	Remittance AdvicePayment-time (remittance)	Claim submitted three months after service date	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
J8	Remittance AdvicePayment-time (remittance)	Coverage Not In Effect; Services Provided On Or After The 20th Of This Month Will Not Be Paid Unless Subscriber Takes Corrective Action	Check the patient eligibility and health card for the service date. If they were covered, file a Remittance Advice Inquiry; otherwise bill the correct payer.
J9	Remittance AdvicePayment-time (remittance)	Coverage Reinstated. Submit Claims Routinely	Check the patient eligibility and health card for the service date. If they were covered, file a Remittance Advice Inquiry; otherwise bill the correct payer.
L1	Remittance AdvicePayment-time (remittance)	This service paid to another laboratory	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
L2	Remittance AdvicePayment-time (remittance)	Not allowed to medical Laboratory Director	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
L3	Remittance AdvicePayment-time (remittance)	Not allowed in addition to other laboratory procedure(s)	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
L4	Remittance AdvicePayment-time (remittance)	Not allowed to attending physicians	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
L5	Remittance AdvicePayment-time (remittance)	Not allowed in addition to other procedure paid to another laboratory	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
L6	Remittance AdvicePayment-time (remittance)	Procedure paid previously to another laboratory, not allowed in addition this procedure-fee adjusted to pay the difference	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
L7	Remittance AdvicePayment-time (remittance)	Not allowed-referred specimen	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
L8	Remittance AdvicePayment-time (remittance)	Not to be claimed with prenatal/fetal assessment	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
L9	Remittance AdvicePayment-time (remittance)	Laboratory services for hospital in-patients or out-patients are not payable on a fee-for-service basis-included in the hospital global budget	Not payable by OHIP under this rule - bill the patient or the correct payer if the service is uninsured, or file a Remittance Advice Inquiry if you believe it qualifies.
LA	Remittance AdvicePayment-time (remittance)	Lab service is funded by special Lab Agreement	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
LS	Remittance AdvicePayment-time (remittance)	Paid in accordance to special Lab Agreement	Informational - the claim was paid (sometimes at an adjusted amount). No action needed unless the amount looks wrong, in which case file a Remittance Advice Inquiry.
M1	Remittance AdvicePayment-time (remittance)	Maximum fee allowed or maximum number of service has been reached same/any provider	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
M2	Remittance AdvicePayment-time (remittance)	Maximum allowance for radiographic examination(s) by one or more practitioners	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
M3	Remittance AdvicePayment-time (remittance)	Maximum fee allowed for prenatal care	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
M4	Remittance AdvicePayment-time (remittance)	Maximum fee allowed for these services by one or more practitioners has been reached	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
M5	Remittance AdvicePayment-time (remittance)	Monthly maximum has been reached	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
M6	Remittance AdvicePayment-time (remittance)	Maximum fee allowed for special visit premium-additional patient seen	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
MA	Remittance AdvicePayment-time (remittance)	Maximum number of sessions has been reached	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
MC	Remittance AdvicePayment-time (remittance)	Maximum number of case conferences has been reached in a 12 month period	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
MD	Remittance AdvicePayment-time (remittance)	Daily maximum has been exceeded	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
ME	Remittance AdvicePayment-time (remittance)	Maximum number of e-assessments paid	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
MM	Remittance AdvicePayment-time (remittance)	Claim does not meet requirements of the Physician Schedule of Benefits	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
MN	Remittance AdvicePayment-time (remittance)	Maximum number of occipital nerve block sessions has been reached	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
MO	Remittance AdvicePayment-time (remittance)	Maximum number of Optical Coherence Tomography (OCT) services has been reached	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
MR	Remittance AdvicePayment-time (remittance)	Minimum service requirements have not been met	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
MS	Remittance AdvicePayment-time (remittance)	Maximum allowed for sleep studies in a specific period by one or more physicians has been reached	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
MX	Remittance AdvicePayment-time (remittance)	Maximum of 2 arthroscopy "R" codes with E595 has been reached	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
MU	Remittance AdvicePayment-time (remittance)	Maximum Units Exceeded	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
MW	Remittance AdvicePayment-time (remittance)	Maximum Number of Weeks has elapsed since payment of initial service	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
MY	Remittance AdvicePayment-time (remittance)	Yearly maximum has been exceeded	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
O1	Remittance AdvicePayment-time (remittance)	Fee for obstetric care apportioned	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
O2	Remittance AdvicePayment-time (remittance)	Previous prenatal care already claimed	OHIP shows this was already paid - confirm it is not a true duplicate; file a Remittance Advice Inquiry with detail if the service was genuinely separate.
O3	Remittance AdvicePayment-time (remittance)	Previous prenatal care already claimed by another doctor	OHIP shows this was already paid - confirm it is not a true duplicate; file a Remittance Advice Inquiry with detail if the service was genuinely separate.
O4	Remittance AdvicePayment-time (remittance)	Office visits relating to pregnancy and claimed prior to delivery included in obstetric fee	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
O5	Remittance AdvicePayment-time (remittance)	Not allowed in addition to delivery	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
O6	Remittance AdvicePayment-time (remittance)	Medical induction/stimulation of labour allowed once per pregnancy	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
O7	Remittance AdvicePayment-time (remittance)	Allowed as subsequent prenatal visit-initial prenatal visit already claimed	OHIP shows this was already paid - confirm it is not a true duplicate; file a Remittance Advice Inquiry with detail if the service was genuinely separate.
O8	Remittance AdvicePayment-time (remittance)	Allowed once per pregnancy	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
O9	Remittance AdvicePayment-time (remittance)	Not allowed in addition to post-natal care	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
P2	Remittance AdvicePayment-time (remittance)	Maximum fee allowed for low birth weight care	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
P3	Remittance AdvicePayment-time (remittance)	Maximum fee allowed for newborn care	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
P4	Remittance AdvicePayment-time (remittance)	Fee for newborn care/low birth weight care is not billable with neonatal intensive care	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
P5	Remittance AdvicePayment-time (remittance)	Over-age for paediatric rates of payment	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
P6	Remittance AdvicePayment-time (remittance)	Over-age for well-baby care	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
P8	Remittance AdvicePayment-time (remittance)	Health Care Connect greater than 3 months	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
P9	Remittance AdvicePayment-time (remittance)	Complex New patient	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
PM	Remittance AdvicePayment-time (remittance)	Minimum roster size not met	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
Q7	Remittance AdvicePayment-time (remittance)	No fee allowed for treatment of immediate family	Not payable by OHIP under this rule - bill the patient or the correct payer if the service is uninsured, or file a Remittance Advice Inquiry if you believe it qualifies.
Q8	Remittance AdvicePayment-time (remittance)	Lab not licensed to perform this test on date of service	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
R1	Remittance AdvicePayment-time (remittance)	Only one health exam allowed in a twelve-month period	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
R2	Remittance AdvicePayment-time (remittance)	10 Well Baby Visits Allowed Up To Two Years Of Age	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
R3	Remittance AdvicePayment-time (remittance)	One Well Child Exam (Age 2-5 Years) Allowed Within A12 Month Period	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
RD	Remittance AdvicePayment-time (remittance)	Duplicate, paid in Reciprocal Medical Billing System (RMBS)	OHIP shows this was already paid - confirm it is not a true duplicate; file a Remittance Advice Inquiry with detail if the service was genuinely separate.
S1	Remittance AdvicePayment-time (remittance)	Bilateral surgery, one stage, allowed at 85% higher than unilateral	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
S2	Remittance AdvicePayment-time (remittance)	Bilateral surgery, two stage, allowed at 85% higher than unilateral	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
S3	Remittance AdvicePayment-time (remittance)	Second surgical procedure allowed at 85%	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
S4	Remittance AdvicePayment-time (remittance)	Procedure fee reduced when paid with related surgery or anaesthetic	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
S5	Remittance AdvicePayment-time (remittance)	Not allowed in addition to major surgical fee	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
S6	Remittance AdvicePayment-time (remittance)	Allowed as subsequent procedure-initial procedure previously claimed	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
S7	Remittance AdvicePayment-time (remittance)	Normal pre-operative and post-operative care included in surgical fee	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
S9	Remittance AdvicePayment-time (remittance)	Initial procedure not found	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
SA	Remittance AdvicePayment-time (remittance)	Surgical procedure allowed at consultation fee	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
SB	Remittance AdvicePayment-time (remittance)	Normal pre-operative visit included in surgical fee-visit fee previously paid-surgical fee adjusted	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
SC	Remittance AdvicePayment-time (remittance)	Not allowed, major pre-operative visit already claimed	OHIP shows this was already paid - confirm it is not a true duplicate; file a Remittance Advice Inquiry with detail if the service was genuinely separate.
SD	Remittance AdvicePayment-time (remittance)	Not allowed, Team/Assist Fee already claimed	OHIP shows this was already paid - confirm it is not a true duplicate; file a Remittance Advice Inquiry with detail if the service was genuinely separate.
SE	Remittance AdvicePayment-time (remittance)	Major pre-operative visit previously paid and admission assessment previously paid-surgery fee reduced by the admission assessment	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
SF	Remittance AdvicePayment-time (remittance)	Most Responsible Physician (MRP) visit not allowed during post- operative period-surgical fee adjusted	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
SN	Remittance AdvicePayment-time (remittance)	Multiple Surgical Anaesthesia. Documentation of Separate Surgeries Same Day/Same Patient Required	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
SV	Remittance AdvicePayment-time (remittance)	MRP visit not allowed during post-operative period-fee reduced to subsequent visit fee	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
SW	Remittance AdvicePayment-time (remittance)	Intensive Care Unit per diem code paid to another physician-MRP subsequent visit reduced to subsequent visit	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
SX	Remittance AdvicePayment-time (remittance)	ICU Per Diem code Paid To Another Physician, MRP Premium Not Allowed	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
T1	Remittance AdvicePayment-time (remittance)	Fee allowed according to surgery claim	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
V1	Remittance AdvicePayment-time (remittance)	Allowed as repeat assessment-initial assessment previously claimed	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
V2	Remittance AdvicePayment-time (remittance)	Allowed as extra patient seen in the home	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
V3	Remittance AdvicePayment-time (remittance)	Not allowed in addition to procedural fee	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
V4	Remittance AdvicePayment-time (remittance)	Date of service was not a Saturday, Sunday or statutory holiday	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
V5	Remittance AdvicePayment-time (remittance)	Only one major oculo-visual examination allowed in a 12-month period for under 19 or over 65 with medical condition; 1 in 18 month period for over 65 withouut medical condition	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
V6	Remittance AdvicePayment-time (remittance)	Allowed as minor assessment-initial assessment already claimed	OHIP shows this was already paid - confirm it is not a true duplicate; file a Remittance Advice Inquiry with detail if the service was genuinely separate.
V7	Remittance AdvicePayment-time (remittance)	Allowed at medical/specific re-assessment fee	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
V8	Remittance AdvicePayment-time (remittance)	This service paid at lower fee as per stated OHIP policy	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
V9	Remittance AdvicePayment-time (remittance)	Only one initial office visit allowed within a twelve-month period	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
VA	Remittance AdvicePayment-time (remittance)	Procedure fee reduced-consultation/visit fees not allowed in addition	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
VB	Remittance AdvicePayment-time (remittance)	Additional Oculo-Visual Assessment (OVA) is allowed once within the second year for patients aged 20-64, following a periodic OVA	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
VC	Remittance AdvicePayment-time (remittance)	Procedure Paid Previously Not Allowed In Addition To Visit Fee. Fee Adjusted To Pay The Difference	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
VG	Remittance AdvicePayment-time (remittance)	Only one geriatric general assessment premium per patient per 12- month period	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
VM	Remittance AdvicePayment-time (remittance)	Oculo-visual minor assessment is only allowed within eligibility period after a major oculo-visual examination	Check the patient eligibility and health card for the service date. If they were covered, file a Remittance Advice Inquiry; otherwise bill the correct payer.
VN	Remittance AdvicePayment-time (remittance)	Allowed as major oculo-visual examination for seniors with medical conditions	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
VP	Remittance AdvicePayment-time (remittance)	Allowed with special visit only	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
VR	Remittance AdvicePayment-time (remittance)	Visit reduced premium not applicable	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
VS	Remittance AdvicePayment-time (remittance)	Date of service was a Saturday, Sunday or statutory holiday	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
VX	Remittance AdvicePayment-time (remittance)	Complexity premium not applicable to visit fee	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
W3	Remittance AdvicePayment-time (remittance)	Warning: - Service date is older than 3 months	Warning only - the claim was processed. Note the issue (for example an aging service date) and submit future claims sooner.
W4	Remittance AdvicePayment-time (remittance)	Warning:-service location indicator code missing	Warning only - the claim was processed. Note the issue (for example an aging service date) and submit future claims sooner.
X2	Remittance AdvicePayment-time (remittance)	Gastrointestinal (G.I.) tract includes cine and video tape	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
X3	Remittance AdvicePayment-time (remittance)	Gastrointestinal (G.I.) tract includes survey film of abdomen	This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
X4	Remittance AdvicePayment-time (remittance)	Only one Bone Mineral Density (BMD) allowed within a 36 month period for a low risk patient	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
X5	Remittance AdvicePayment-time (remittance)	Only one Bone Mineral Density (BMD) allowed within a 12 month period for a high risk patient	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
X6	Remittance AdvicePayment-time (remittance)	Only one Bone Mineral Density (BMD) allowed within a 60 month period for a low risk patient	The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
No codes match that search. Try the code on its own (e.g. “EH4”), or check the Ministry’s full list linked below.

Why This Guide Exists

You submit a clean-looking day sheet, and a week later a handful of claims come back with a cryptic two- or three-character code beside them. EH2. VH9. A2A. Code 35. Nobody teaches you these in residency, and the official Ministry of Health lists run to hundreds of entries with terse, jargon-heavy descriptions.

This page decodes the OHIP error and explanatory codes new Ontario physicians hit most, tells you in plain language what each one means, and gives you a concrete next step for each. Use the search box above to jump straight to a code, or read on for how the whole system fits together.

Who this guide is for:

New graduates reconciling their first OHIP remittance and seeing rejections for the first time
Physicians who self-bill and want to clear errors without a billing agent
Anyone trying to understand why a claim was reduced, held, or paid at $0

First, Know Which Report You're Looking At

OHIP gives you feedback in two different places, and the kind of code tells you which one. Getting this distinction right saves you from chasing the wrong fix.

Where you see it	What it is	Code format	What it means
Claims Error Report	Returned within a few days of submission, before payment	Three characters (e.g. EH2, VH9, A2A)	The claim was rejected up front. It was never paid. Fix it and resubmit.
Remittance Advice (RA)	Your monthly payment statement from the Ministry	Two digits (e.g. 35, 50, 55)	The claim was accepted but adjusted, reduced, or disallowed at payment time.

The 3-month rule. A rejected claim must be corrected and resubmitted within 3 months (technically, before it stale-dates 6 months from the service date - but aim for 3 to leave room for a second rejection). Do not let error reports pile up. The single biggest cause of lost OHIP income for new physicians is unworked error reports, not low fees.

The Three Families of Codes

Every code in the searchable lookup above falls into one of three buckets. Knowing the bucket tells you where to look and what kind of fix to expect.

Health card & eligibility

By far the most common category - EH2, VH1, VH9, EH4, EH5, EH1, VH2, VH4, VH8 and friends. Almost all of them come down to the health number, version code, or date of birth not matching the Ministry's Registered Persons Database on the date of service. Validating the card at the point of care (Health Card Validation, or HCV) prevents most of them, and most are a quick correct-and-resubmit once you have the right number.

Out-of-province patients are a frequent hidden cause here. A Quebec card will never clear OHIP - you have to use a RAMQ pathway instead. See the RAMQ guide for the three options. For international students, the UHIP guide covers the equivalent.

Service, code & diagnosis

These rejections - V21, A2A, V20, AD1, A1A, AC1 - are about the content of the claim itself: the fee code, the diagnostic code, the patient's age, a missing element, or a service maximum, rather than the patient's coverage. The fix is usually to correct the code, add the missing 3-digit diagnostic code, attach the base service a premium depends on, or confirm a frequency limit (some assessments and consults are payable only once in a given period).

Payment-time (remittance) codes

Two-digit codes - 50, 35, 55, 57, 30, 36, 41, 42 - appear on the monthly Remittance Advice against claims that were accepted but adjusted. Some are purely informational (a 50 just means it paid, sometimes at a different amount); others tell you money was reduced or clawed back; and a few, like 55 and 57, net to zero and exist only for reconciliation. When you believe a reduction is wrong, the channel is a Remittance Advice Inquiry, below.

The lookup above covers the Ministry's full code lists end to end: every three-character code from the Error Report Rejection Conditions (December 2022) that can appear on your Claims Error Report, and every two-character code from the Remittance Advice Explanatory Codes / Messages (March 2026) that can appear on your monthly Remittance Advice - each with its official Ministry wording. The Ministry revises these periodically through OHIP INFOBulletins, so confirm against the current publications before you act. The meanings are the Ministry's wording; the suggested actions are general guidance, not billing advice.

A Repeatable Way to Work an Error Report

However your billing software presents errors, the workflow is the same. Run it the same way every cycle and rejections stop being scary.

1.Pull the report the moment it arrives - error reports a few days after submission, the Remittance Advice monthly. Don't wait for month-end to look at submission rejections.
2.Sort by code. Group the rejections so you fix all the EH2s together, all the V21s together, and so on. The same fix usually clears the whole group.
3.Decide: fix or write off. Most health-card and coding errors are fixable and worth resubmitting. A genuinely uninsured patient (EH5) is a write-off or a patient bill, not a resubmission.
4.Correct the claim - update the version code, fix the number, add the diagnostic code, attach the base service.
5.Resubmit inside the window. Watch the service date: you have until it stale-dates. Resubmit promptly so a second rejection still leaves you time.
6.If you disagree, file a Remittance Advice Inquiry (see below) rather than resubmitting the same claim unchanged.

When You Think the Rejection Is Wrong

Sometimes the Ministry reduces or rejects a claim you believe was correct. Resubmitting the identical claim will just get rejected again. The right channel is a Remittance Advice Inquiry (RAI).

Submit a Remittance Advice Inquiry on the Ministry's form (0918-84), or electronically through your billing software / eSubmit where supported.
Reference the specific claim, the explanatory code, and why you believe the original submission was correct.
Keep the deadline in mind: inquiries are also time-limited, so don't sit on a disputed reduction.
Document your reasoning in the patient record in case the Ministry asks for supporting detail.

How MedConcierge Helps

Working error reports by hand - downloading files, decoding codes, hunting for supporting documents - is where new physicians lose the most time and money. MedConcierge does the heavy lifting:

Pulls your error reports and monthly Remittance Advice automatically every cycle, so nothing sits unworked and nothing stale-dates without you seeing it.
Flags every rejected and reduced claim for you - sorted and grouped by code - instead of leaving you to comb through a raw file.
Explains each code in plain language and suggests the likely fix, from a wrong version code to a missing diagnostic code or a premium billed without its base service.
Validates health cards before you submit, catching the EH and VH errors above before they ever become a rejection.
Lets you correct and resubmit, or file a manual review / Remittance Advice Inquiry - with your notes and supporting documents attached - right inside the system, instead of mailing paper forms.
And if you spot a fee or code that looks wrong, the built-in contributor tools let you report it in two taps and earn points toward a say in what we build next.

This guide is general information for Ontario physicians, not billing, legal, or tax advice. Code meanings are summarized for clarity and OHIP updates them periodically - always confirm against the current Ministry of Health Remittance Advice Explanatory Codes and Error Report Rejection Conditions documents, and validate eligibility through Health Card Validation before you rely on a claim.

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This guide is for general information for Ontario physicians and is not legal, tax, or billing advice. Programs and fees change — verify current details with the relevant payor before you rely on them.