Error code
F5 — Two weeks aftercare included in fracture fee
Included in fracture fee
A visit in the two weeks after fracture treatment is included in the fracture fee, so it wasn't paid separately.
What to do: If the visit was for a different problem, send a remittance advice inquiry with chart notes within 7 months.
- Code
- F5
- Description
- Two weeks aftercare included in fracture fee
Explanation
Updated October 26, 2026
F5: visits in the two weeks after fracture treatment are included in the fracture fee, so they weren't paid separately.
What it means
F5 means OHIP did not pay a visit separately because the after-care given in the two weeks after a fracture or dislocation treatment is included in the fracture fee.
The Schedule describes the full fracture benefit as covering the reduction and after-care (Schedule N2, rule 6). The major pre-operative visit (consultation or assessment) can still be billed on top of the fracture fee (Schedule N1, rule 1).
How to fix it
- Check whether the visit was for the treated fracture.
- If the visit was for a different problem, send a Remittance Advice Inquiry (RAI) through eSubmit, or on form 0918-84, within 7 months of the RA date, with the chart notes.
- If it was routine fracture follow-up, there is nothing to fix, except in-hospital subsequent or concurrent care visits from April 1, 2026, which are now paid in full (INFOBulletin 260901).
Don't resubmit if
- The claim is already on your RA. Use an RAI, not a new claim, if you disagree.
- The visit was routine follow-up for the treated fracture.
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