Remittance Advice · Payment-time (remittance)
OHIP explanatory code O4
Office visits relating to pregnancy and claimed prior to delivery included in obstetric fee
What O4 means
The Ministry of Health’s official wording for O4 is: “Office visits relating to pregnancy and claimed prior to delivery included in obstetric fee.”
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 O4
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.
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
- MYYearly maximum has been exceeded
- O1Fee for obstetric care apportioned
- O2Previous prenatal care already claimed
- O3Previous prenatal care already claimed by another doctor
- O5Not allowed in addition to delivery
- O6Medical induction/stimulation of labour allowed once per pregnancy
- O7Allowed as subsequent prenatal visit-initial prenatal visit already claimed
- O8Allowed once per pregnancy
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Code meaning per Ontario Ministry of Health — Remittance Advice Explanatory Codes / Messages (March 2026). The suggested action is general information for Ontario physicians, not billing, legal, or tax advice — codes and rules change, so verify against the current Ministry of Health documents before relying on a claim.