Remittance Advice · Payment-time (remittance)
OHIP explanatory code S5
Not allowed in addition to major surgical fee
What S5 means
The Ministry of Health’s official wording for S5 is: “Not allowed in addition to major surgical 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 S5
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
- S1Bilateral surgery, one stage, allowed at 85% higher than unilateral
- S2Bilateral surgery, two stage, allowed at 85% higher than unilateral
- S3Second surgical procedure allowed at 85%
- S4Procedure fee reduced when paid with related surgery or anaesthetic
- S6Allowed as subsequent procedure-initial procedure previously claimed
- S7Normal pre-operative and post-operative care included in surgical fee
- S9Initial procedure not found
- SASurgical procedure allowed at consultation fee
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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.