OHIP Remittance Advice code O4
Office visits relating to pregnancy and claimed prior to delivery included in obstetric fee
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
- MX · Maximum of 2 arthroscopy "R" codes with E595 has been reached
- MY · Yearly maximum has been exceeded
- O2 · Previous prenatal care already claimed
- O3 · Previous prenatal care already claimed by another doctor
- O6 · Medical induction/stimulation of labour allowed once per pregnancy
- O8 · Allowed once per pregnancy
- P2 · Maximum fee allowed for low birth weight care
- P3 · Maximum fee allowed for newborn care