OHIP explanatory code L9

What L9 means

The Ministry of Health’s official wording for L9 is: “Laboratory services for hospital in-patients or out-patients are not payable on a fee-for-service basis-included in the hospital global budget.”

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 L9

Laboratory services for hospital in-patients/out-patients are funded through the hospital's global budget, not fee-for-service - do not bill the patient. Seek remuneration through the hospital, or file a Remittance Advice Inquiry if the patient wasn't a hospital in/out-patient.

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

• L5Not allowed in addition to other procedure paid to another laboratory
• L6Procedure paid previously to another laboratory, not allowed in addition this procedure-fee adjusted to pay the difference
• L7Not allowed-referred specimen
• L8Not to be claimed with prenatal/fetal assessment
• LALab service is funded by special Lab Agreement
• LSPaid in accordance to special Lab Agreement
• M1Maximum fee allowed or maximum number of service has been reached same/any provider
• M2Maximum allowance for radiographic examination(s) by one or more practitioners