OHIP Remittance Advice code DE
Lab tests already paid-visit fee adjusted
Ontario Ministry of Health, Remittance Advice Explanatory Codes
Where you’ll see it
On your Remittance Advice. The claim was assessed, and this explanatory code says how it was paid, reduced or refused. The Remittance Advice arrives monthly, in the first week.
Resubmitting usually won't change this
OHIP considers the service already paid, claimed by someone else, over its limit, or not insured. A corrected resubmission generally won't be paid. If you believe OHIP's records are wrong, raise it with the ministry instead of resubmitting.
For a claim already on your Remittance Advice, follow the ministry's instruction in the description. That is either a corrected resubmission or a Remittance Advice Inquiry (RAI), and both are still subject to the three-month limit from the date of service.
Our summary is a guide, not a ruling. The ministry’s wording and the current Schedule of Benefits are what OHIP applies. See OHIP Error Report vs Remittance Advice: reading the codes for how the two reports differ.
Related Remittance Advice codes
- D5 · Procedure already allowed-visit fee adjusted
- D6 · Limit of payment for this procedure reached
- DA · Maximum for this procedure reached paid as repeat/chronic procedure
- DB · Other dialysis procedure already paid
- DG · Diagnostic/Miscellaneous services for hospital patients are not payable on a fee-for-service basis in the Hospital Global budget.
- DV · Service is included in Monthly Management Fee for Long-Term Care (LTC) patients
- DW · Procedure paid previously not allowed in addition to monthly management. For long-term care patients-fee adjusted to pay the difference.
- F5 · Two weeks aftercare included in fracture fee