OHIP Remittance Advice code P9

Remittance Advice
Coding problem

Complex New patient

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.

The fee code doesn't fit this claim

The service code billed doesn't fit the claim as submitted: wrong for the date, the patient, or the other codes on the same claim. Check the Schedule of Benefits rule for the code, choose the one that matches what was done, and resubmit.

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

  • O9 · Not allowed in addition to post-natal care
  • P4 · Fee for newborn care/low birth weight care is not billable with neonatal intensive care
  • P5 · Over-age for paediatric rates of payment
  • P6 · Over-age for well-baby care
  • S5 · Not allowed in addition to major surgical fee
  • S6 · Allowed as subsequent procedure-initial procedure previously claimed
  • S9 · Initial procedure not found
  • SA · Surgical procedure allowed at consultation fee

Know what P9 means before the claim comes back.

Med Copilot records the ministry's codes against each returned claim, explains them, and tells you which ones re-coding can fix. Fourteen days free.

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