OHIP Error Codes
A key part of medical billing in Ontario is reconciling your OHIP claims. Even the best billing agents experience the occasional error code and rejected claims. It’s frustrating but necessary to ensure payments are fair and accurate.
To help make things easier, we’ve compiled the most common OHIP error codes. You can find the error code using our unprocessed claims report. Each page below has a full explanation of the error and how to fix it. In most cases, you will need to resubmit the claim or complete an RA inquiry.
We’ve grouped the errors into buckets to make it easier to find what may be causing the issue with your claim. Click on the link to jump to the most appropriate section.
- Patient Errors
- Service Errors
- Referral Errors
- Provider Billing Number / Group Number Errors
- Facility Number (Location) / Admission Date Errors
- Service Date Errors
- Specialty Errors
- Virtual Care Service Errors
- Reciprocal Medical Billing (RMB) Errors
- Diagnostic Code Errors
Patient Errors
A2A – Patient is underage or overage for this service code
EH1 – Service date is greater than eligibility end date
EH4/EH5 – OHIP Number Not Valid on the Date of Service
EP3 – Check Service Date / Enrolment Date
EPF – Enrollment Date Mismatch
HCC – Not on Health Care Connect (HCC) database
HCE – HCE Enrolment After 3 months
VH1 / VH4 / VH9 – OHIP number not valid
Service Errors
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 Number of ser FSM ref MC
AD1/AD9 – Corresponding procedure not claimed/Premium not allowed alone
AD5 – Service code only allowed once per patient per day
ADF – Corresponding procedure invalid, omitted or paid at zero
AMR – Minimum service requirements have not been met
AO3 – Claimed by Other Practitioner
ASP – Not allowed with surgical procedure
DF – Corresponding procedure invalid, omitted, or is paid at zero
V39 – Number of items exceeds the maximum (99)
Referral Errors
AC4 / ARF – Invalid Referral Number
ENP – Invalid service code for Nurse Practitioner referrals
ERF / EQ6 – Inactive or invalid referring physician
Provider Billing Number / Group Number Errors
EQ1- Health care provider is not registered
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 the group
ESD – APP Group Affiliation on Service Date
ESF – A non-encounter service claim submitted by a physician not eligible to bill FSC codes
Facility Number (Location) / Admission Date Errors
AH5 – Invalid hospital admission date
AH8 – Hospital and/or Admission Date is missing or invalid
V64 – Missing Service Location Indicator (SLI)
V67 – Missing master number and admission date
V68 – Incorrect Service Location Indicator
V69 – Service date invalid for SLI
Service Date Errors
V70 – Date of service is greater than the batch/file creation date
Specialty Errors
EQ2 – Specialty code is inactive or not registered on date of service
A4D – Invalid specialty for this service code
Virtual Care Service Errors
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
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
TM5 – Virtual Care Claim Already Paid for This Patient
TM6 – Virtual Care Program Registration Not in Effect on Service Date
TM7 – Dental Services Not Payable Under Virtual Care Program
Reciprocal Medical Billing (RMB) Errors
R02/R03 – Reciprocal medical billing error
Diagnostic Code Errors
V16 – Unacceptable Diagnostic Code