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OHIP Rejection Code Library
OHIP Rejection Code Library

Learn how to fix OHIP rejections and get your claims paid

Sophia Jarvi avatar
1 author77 articles
VTC - Virtual Tech Code Required
A2A - Patient is underage or overage for this service code
A2B – This service is not normally performed for this sex
A3F – No fee exists for this service code on this date of service
A34 - Duplicate service codes submitted
A36 - Claimed by Other Practitioner
A3E - No such service code for date of service
A3H - Max # Ser FSM Ref MC
A4D - Invalid specialty for this service code
AC1 - Rejection (AC1 Error) - Maximum reached
AC4 / ARF - Invalid Referral Number
AD1 / AD9 - Corresponding procedure not claimed/Premium not allowed alone
AD5 - Service code only allowed once per patient per day
ADF/DF - Corresponding procedure invalid, omitted or paid at zero
AH5 - Invalid hospital admission date
AH8 - Hospital and/or Admission Date is missing or invalid
ASP - Not allowed with surgical procedure
VW1 – Invalid WCB Service
AH9 – Diagnostic/miscellaneous service for hospital patient is not allowed on a fee-for-service basis – included in the hospital global budget
Rejection - Incorrect District Code
AMR - Minimum service requirements have not been met
AO3 - Service claimed by another practitioner
CNA - Counselling not allowed
EG1 - Group not Eligible
EH1 – Service date is greater than eligibility end date
EH2 - Invalid Version Code
EH4/EH5 - OHIP Number Not Valid on Date of Service
EH6 - Patient deceased
ENP - Invalid service code for Nurse Practitioner referrals
EP3 - Check Service Date / Enrolment Date
EPF - Enrollment Date Mismatch
EQ1- Health care provider is not registered
EQ2 - Specialty code is inactive or not registered on date of service
EQB - Inactive provider billing number
EQC - Group number is not registered
EQD - Group number is not registered
EQE - Healthcare provider not registered as an affiliate of group
EQF - Healthcare provider is not ACTIVELY registered
EQG - Referring laboratory is not registered with the Ministry of Health
ERF / EQ6 - Inactive or invalid referring physician
ESD – APP Group Affiliation on Service Date
ESF – A non-encounter service claim submitted by a physician not eligible to bill FSC codes
ET1 - Provider Not Registered for Virtual Care Program
ET4 - Virtual Care Program B-Code Missing or SLI Code Invalid
ET5 - Virtual Care Program SLI Code Missing
HCC - Not on Health Care Connect (HCC) database
HCE - HCE Enrolment After 3 months
R02 / R03 - Reciprocal Medical Billing Error
R08 - Invalid referral number
TM1 - Duplicate Virtual Care Claim for Same Patient
TM3 - Service Not Payable Under Virtual Care Program
TM4 - Non-Virtual Care Claim Already Paid for This Patient
TM6 - Virtual Care Program Registration Not in Effect on Service Date
TM5 - Virtual Care Claim Already Paid for This Patient
TM7 - Dental Services Not Payable Under Virtual Care Program
V08 - Invalid specialty code
V09 - Invalid referral number
V16 - Unacceptable Diagnostic Code
V21 - Diagnostic Code Required
V22 - Invalid diagnostic code
V23 - Check no. of services
V28 – Invalid Hospital Number
V30 - FSC / DX code Combination NAB
V35 - Invalid OOP/OOC Service
V39 - Number of items exceeds the maximum (99)
V64 – Missing Service Location Indicator (SLI)
V65 - Missing master number
V66 – Missing Admission Date
V67 – Missing master number and admission date
V68 - Incorrect Service Location Indicator
V69 – Service date invalid for SLI
V70 - Date of service is greater than the batch/file creation date
VH1 / VH4/ VH9 - OHIP number not valid
VH2 – HN is Missing
VH8 - No match on DOB with HN
VHB - No HN Req’d for FSC
VJ7/VJ8 - Stale dated claim