OHIP explanatory code C7

What C7 means

The Ministry of Health’s official wording for C7 is: “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 code appears as an explanatory code on your monthly Remittance Advice (RA). It means the claim was adjudicated — paid, reduced, or refused — for the reason below. A claim already on your RA generally shouldn't be blindly resubmitted; follow the suggested action.

How to fix C7

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.

Payment-time codes appear on the monthly Remittance Advice after adjudication. Some are informational, some explain a reduced or refused payment. Where you disagree with the outcome, the usual route is a Remittance Advice Inquiry or written inquiry — not resubmitting the same claim, which can create a duplicate.

Related codes

• C3Allowed at minor assessment fee
• C4Consultation not allowed with this service-paid as assessment
• C5Allowed as multiple systems assessment
• C6Allowed as Type 2 admission assessment
• C8Payment reduced to geriatric consultation fee-maximum number of comprehensive geriatric consultations has been reached
• C9Allowed as in-patient interim admission orders-initial assessment already claimed by other physician
• D1Allowed as repeat procedure-initial procedure previously claimed
• D2Additional procedures allowed at 50%