OHIP REJECTION & ERROR CODES

OHIP Rejection Code Lookup

Find your error code, understand what went wrong, and fix it fast. Claims Error Report codes and fix instructions for Ontario physicians — all in one place. Free — no signup required.

427 codes: Error Report, MCEDT & RA 93 codes with fix instructions (OpsMed-authored) Cross-linked to fee & diagnostic tools Free — no account required

Regulatory Currency

This guide reflects the following MOH INFOBulletins:

  • 260312 — New and Updated Explanatory Codes (Apr 8, 2026)

Last verified: April 16, 2026

What Are OHIP Rejection Codes?

OHIP rejection codes are 2–3 character error identifiers returned when a claim is rejected at submission (Claims Error Report) or adjusted at payment (Remittance Advice). Common codes include VH1 (invalid health card), V21 (missing diagnostic code), A2A (service not eligible), and VJ7 (stale-dated claim). Rejected claims must be corrected and resubmitted within 3 months of the service date.

Getting too many rejections? OpsMed is designed to handle standard OHIP billing at 1.5% — built to catch common rejection causes before submission.

Understanding Your Claims Error Report

What is the Claims Error Report?

When you submit claims via MCEDT, OHIP processes them and returns a Claims Error Report listing any rejected items. Each rejected claim shows a 3-character error code — like V21 or VH1 — that identifies exactly why it was rejected. You must correct these errors and resubmit within 3 months of the service date.

Error Report vs. Remittance Advice

The Claims Error Report shows claims rejected at submission time — before any payment. These get a 3-character code (A2A, V21, VH1, etc.). The monthly Remittance Advice (RA) shows claims that were accepted but later modified or disallowed at payment time — these get 2-character RA codes (DX, DS, E1, EB, etc.). This tool now covers all three types: Error Report codes, MCEDT transport errors, and 225 RA explanatory codes.

The 3-month resubmission window

You have 3 months from the service date to correct and resubmit any rejected claim electronically. After 3 months, the claim is stale-dated (error code VJ7 or VJ8) and cannot be resubmitted electronically. For stale-dated claims, submit a Remittance Advice Inquiry (RAI) form to your MOHLTC district office with supporting documentation.

Disputing a rejected claim (RAI)

If you believe a claim was incorrectly rejected, or the rejection is due to circumstances outside your control, you can submit a Remittance Advice Inquiry (RAI) on Form 0918-84, or electronically via eSubmit. The RAI process applies to both Error Report rejections (after the 3-month window) and RA adjustments. Include documentation supporting the claim.

Most common root causes: The majority of OHIP rejections fall into four categories: (1) missing or invalid diagnostic codes (V21, V22, V16, V30), (2) health card issues (VH1, VH2, EH1–EH6), (3) fee code eligibility (A2A, A2B, A3F, A3H), and (4) referral/provider registration problems (AC4, EQ1, EQ2).
OpsMed is designed to handle standard OHIP billing for Ontario practices at 1.5% of paid claims. Our billing engine monitors error reports daily, addresses rejections within 24 hours, and is built to prevent the most common errors before submission. Get a free billing assessment →

Need a diagnostic code? → OHIP Diagnostic Code Lookup   |   Need to check a fee code? → OHIP Fee Code Lookup   |   Worried about stale dates? → OHIP Billing Cut-Off Calendar

Frequently Asked Questions

What is an OHIP claims error report?

The OHIP Claims Error Report is a file physicians receive through MCEDT that lists individual claims rejected at the time of submission. Each rejected claim shows a 3-character error code indicating the specific reason for rejection. Common examples include V21 (missing diagnostic code), VH1 (invalid health card number), and A2A (patient age outside the eligible range for the fee code).

How many OHIP error codes are there?

This tool contains 427 billing codes covering all three types of OHIP adjustments: approximately 188 Error Report codes (from the December 2022 MOH document), 14 MCEDT transport error codes, and 225 Remittance Advice (RA) explanatory codes (MOH, September 2023). Error Report codes are organized into categories including General, Health Number, ICHSC, RMB, Telemedicine, and WCB. RA codes cover payment adjustments, eligibility, service restrictions, maximums, virtual care, surgical, laboratory, obstetrics, and more.

What does rejection code V21 mean?

V21 means "Diagnostic Code Required" — your claim is missing a required 3-digit OHIP ICD-8 diagnostic code. Most assessment and procedure codes require a diagnostic code to explain the reason for the visit. To fix: add the correct diagnostic code and resubmit. Use the OpsMed Diagnostic Code Lookup to find the right code.

What does rejection code VJ7 mean?

VJ7 means "Stale-dated Claim" — the service date on the claim is more than 3 months old. OHIP's standard stale-date policy requires claims to be submitted within 3 months of the service date. Stale-dated claims cannot be resubmitted electronically. Submit a Remittance Advice Inquiry (RAI) to your MOHLTC district office with supporting documentation.

How do I fix a rejected OHIP claim?

Find your rejection code in this tool, read the plain-English explanation and fix instructions, then correct the claim in your billing software and resubmit. Most rejection codes can be fixed and resubmitted within the 3-month stale-date window. For stale-dated claims (VJ7, VJ8), submit a Remittance Advice Inquiry (RAI) form instead.

How long do I have to fix and resubmit a rejected OHIP claim?

You have 3 months from the date of service to correct and resubmit a rejected claim electronically via MCEDT. If more than 3 months have passed, the claim is considered stale-dated (error code VJ7 or VJ8) and cannot be submitted electronically. For stale-dated claims, submit a Remittance Advice Inquiry (RAI) to your MOHLTC district office with supporting documentation.

What is the difference between an error report code and a remittance advice code?

Error report codes (3-character alphanumeric codes like V21, VH1, A2A) appear on the OHIP Claims Error Report when a claim is rejected at submission time — before payment. Remittance Advice (RA) codes (2-character codes like DX, DS, E1, EB) appear on the monthly Remittance Advice when a claim that was accepted is later modified, reduced, or disallowed at payment time. This tool now covers all three: Error Report codes (188), MCEDT transport errors (14), and RA explanatory codes (225) — 427 codes in total.

Data sources: Error Report Rejection Conditions / Error Codes (MOH, December 2022) | Remittance Advice Explanatory Codes/Messages (MOH, September 2023)

Published under the Ontario Open Government Licence. Last updated: April 2026.

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