Error code
C5 — Allowed as multiple systems assessment
Paid as multiple systems assessment
This emergency department assessment was paid at the multiple systems assessment fee instead of the code billed.
What to do: Compare your chart with the billed code's requirements; send an inquiry only if all its elements are documented.
- Code
- C5
- Description
- Allowed as multiple systems assessment
Explanation
Updated October 26, 2026
OHIP paid this emergency department assessment as a multiple systems assessment instead of the fee code you billed.
What it means
Code C5 means the assessment was paid at the multiple systems assessment fee. In the emergency department or a hospital urgent care clinic, that is an assessment with a detailed history and exam of more than one system, part or region (A15).
The higher-paying comprehensive assessment and care needs a full history (including systems review, past history, medication review and social evaluation), a full physical exam, concomitant treatment, and intermittent attendance over many hours (A15). The Ministry doesn't say why your claim was reduced.
Common causes
- A comprehensive assessment and care code billed when the chart supports a multiple systems assessment
How to fix it
- Compare your chart with the requirements for the code you billed.
- If all the comprehensive assessment and care elements are documented, send a Remittance Advice Inquiry (RAI) through eSubmit, or on form 0918-84, within 7 months of the RA date, with supporting details such as your chart notes.
- Otherwise, the lower payment stands.
Don't resubmit if
- The claim is already on the RA and you only disagree with the decision. Use an RAI, not a new claim.
How APEX handles it
APEX reads your error reports and remittance advice from MCEDT and lists claims rejected with this code in its Correction Centre for you to correct and resubmit. See how APEX works · Pricing