How do I fix OHIP error code 40?

Search the patient's billing history for the same fee code and for related codes. Check the code's limit and payment rules in the Schedule of Benefits. If the service was paid before, nothing more is owed under that code. If a different code correctly describes what you did this time, bill that code. If you believe the earlier claim was a different service, or nothing was paid before, send a Remittance Advice Inquiry (RAI) through eSubmit, or on form 0918-84, within 7 months of the RA date. Explain why this service is separate.

When shouldn't I resubmit a 40 claim?

The once-only service has already been paid for this patient. You'd be sending the same fee code again. It will get the same result. The claim is on the RA and you want to dispute it. Use an RAI.

< Error codes

Error code

40 — Service or related service allowed only once for same patient

Q: What does OHIP error code 40 mean?

Code 40 means OHIP allows this service, or a related one, only once for the patient, and it was already paid. Find the earlier claim before doing anything.

Once-only service already paid

OHIP allows this service, or a related one, only once for the patient, and it was already paid.

What to do: Search the patient's billing history for the same and related fee codes before doing anything.

Code: 40
Description: Service or related service allowed only once for same patient

Explanation

Updated October 26, 2026

Code 40 means OHIP allows this service, or a related one, only once for the patient, and it was already paid. Find the earlier claim before doing anything.

What it means

Code 40 is a remittance advice explanatory code. The Ministry's wording is 'Service or related service allowed only once for same patient'. OHIP found that this service, or one it treats as related, was already paid for the patient, so this claim wasn't paid as billed.

Some services in the Schedule of Benefits have once-only or lifetime limits. Examples: G813 corneal pachymetry, once per patient per lifetime (J92), and G394 vaginal vault cervical screening after hysterectomy for dysplasia, once per patient per lifetime (J47).

Because the wording includes 'related service', the earlier paid claim may be under a different fee code, and may have been billed by another physician.

Common causes

The once-only service was already paid for the patient, to you or to another physician
A related code covering the same service was paid earlier
The service was billed again for a repeat that the Schedule doesn't pay

How to fix it

Search the patient's billing history for the same fee code and for related codes.
Check the code's limit and payment rules in the Schedule of Benefits.
If the service was paid before, nothing more is owed under that code. If a different code correctly describes what you did this time, bill that code.
If you believe the earlier claim was a different service, or nothing was paid before, send a Remittance Advice Inquiry (RAI) through eSubmit, or on form 0918-84, within 7 months of the RA date. Explain why this service is separate.

Don't resubmit if

The once-only service has already been paid for this patient.
You'd be sending the same fee code again. It will get the same result.
The claim is on the RA and you want to dispute it. Use an RAI.

How APEX handles it

APEX has no correction rule for code 40 and doesn't send inquiries for it. If nothing on the visit was paid, the claim is listed under Outstanding for you to review and correct. Otherwise the line stays in your claims with the billed and paid amounts. See how APEX works · Pricing

Related codes: M1, M4, 35, 36