How do I fix OHIP error code DX?

Look up the fee code in the Schedule of Benefits and check which diagnoses it requires. Compare that with the patient's record and the diagnostic code on the claim. If the claim had the wrong diagnostic code, send a Remittance Advice Inquiry (RAI) through eSubmit, or on form 0918-84, within 7 months of the RA date, with the correct code. If the patient's diagnosis doesn't qualify for the fee code, bill the code that fits the service instead.

When shouldn't I resubmit a DX claim?

The patient's diagnosis doesn't meet the fee code's requirements. The claim is already on your RA. A new claim for the same service will be treated as a duplicate. Use an RAI instead.

< Error codes

Error code

DX — Diagnostic code not eligible with Fee Schedule Code

Q: What does OHIP error code DX mean?

DX means the diagnostic code on the claim isn't accepted with this fee code. Check the Schedule and use a diagnostic code that fits.

Diagnosis not accepted with code

The diagnostic code on the claim isn't eligible with the fee code billed, so the line is usually refused or paid $0.

What to do: Check which diagnoses the fee code requires; if the diagnostic code was wrong, send a remittance advice inquiry.

Code: DX
Description: Diagnostic code not eligible with Fee Schedule Code

Explanation

Updated October 26, 2026

DX means the diagnostic code on the claim isn't accepted with this fee code. Check the Schedule and use a diagnostic code that fits.

What it means

DX appears on the Remittance Advice (RA) when the diagnostic code on the claim is not eligible with the fee schedule code billed. Some fee codes are only payable with certain diagnoses, and some diagnoses can't be paired with certain services.

The line is usually refused or paid at $0.

Common causes

A fee code that is only payable for specific diagnoses was billed with a different diagnostic code
A typing error in the diagnostic code
A default or generic diagnostic code was used where the fee code needs a specific one

How to fix it

Look up the fee code in the Schedule of Benefits and check which diagnoses it requires.
Compare that with the patient's record and the diagnostic code on the claim.
If the claim had the wrong diagnostic code, send a Remittance Advice Inquiry (RAI) through eSubmit, or on form 0918-84, within 7 months of the RA date, with the correct code.
If the patient's diagnosis doesn't qualify for the fee code, bill the code that fits the service instead.

Don't resubmit if

The patient's diagnosis doesn't meet the fee code's requirements.
The claim is already on your RA. A new claim for the same service will be treated as a duplicate. Use an RAI instead.

How APEX handles it

APEX reads your error reports and remittance advice from MCEDT and, for many claims rejected with this code, works out the fix for you to approve before it is resubmitted. See how APEX works · Pricing

Related codes: V30, V22, V21, V20