Claims Submission Ontario Health Insurance Program
Resource Manual for Physicians
 
4.13   Explanatory Codes (Continued)

Independent Health Facilities Services

FF Additional payment for the claim shown.
I 2 Service is globally funded.
I 3 FSC is not on the IHF licence profile for the date specified.
I 4 Records show service has been rendered by another Practitioner, Group or IHF.
I 5 Service is globally funded and FSC is not on IHF licence profile.

Laboratory

L1 This service paid to another laboratory.
L2 Not allowed to non-medical Laboratory Director.
L3 Not allowed in addition to this laboratory procedure.
L4 Not allowed to attending physicians.
L5 Not allowed in addition to other procedure paid to another laboratory.
L6 Procedure paid previously to another laboratory, not allowed in addition this procedure - fee adjusted to pay the difference.
L7 Not allowed - referred specimen.
L8 Not to be claimed with prenatal / feotal assessment as of July 1, 1993.
L9 Laboratory services for hospital in-patients or out-patients are not payable on a fee-for-service basis - included in the hospital global budget.
LS Paid in accordance to special Lab Agreement.

Paediatric Care

P2 Maximum fee allowed for low birth weight care.
P3 Maximum fee allowed for newborn care.
P4 Fee for newborn care does not apply when newborn baby is ill.
P5 Over-age for paediatric rates of payment.
P6 Over-age for well-baby care.

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