How do I fix OHIP error code P4?

Check the dates of the neonatal intensive care claims and the newborn care claim. If the baby was receiving neonatal intensive care, the newborn care line is not payable. Once neonatal intensive care stops, the usual consultation, assessment and procedure fees apply (critical care per diem listings, J30, note G). Bill those for later care. If the dates don't overlap and you think the line was refused in error, send an RAI. Send it through eSubmit, or on form 0918-84, within 7 months of the RA date.

When shouldn't I resubmit a P4 claim?

The baby was receiving neonatal intensive care on the same days. The claim is already on your Remittance Advice. Use an RAI, not a new claim.

< Error codes

Error code

P4 — Newborn/low birth weight care not billable with neonatal intensive care

Q: What does OHIP error code P4 mean?

P4 means newborn or low birth weight care can't be paid alongside neonatal intensive care for the same baby. NICU fees include the assessments.

Baby in neonatal intensive care

Newborn or low birth weight care can't be paid when neonatal intensive care was billed for the same baby.

What to do: Compare the neonatal intensive care dates with the newborn care claim; if they overlap, the line isn't payable.

Code: P4
Description: Newborn/low birth weight care not billable with neonatal intensive care

Explanation

Updated October 26, 2026

P4 means newborn or low birth weight care can't be paid alongside neonatal intensive care for the same baby. NICU fees include the assessments.

What it means

Code P4 means OHIP did not pay newborn care or low birth weight care because neonatal intensive care was billed for the same baby.

Neonatal intensive care (G600 to G621) covers all aspects of care for intensive care area patients for the day, including the initial consultation or assessment and later assessments (J33). Routine newborn care is for well newborns (GP32), so it doesn't fit alongside these per diem fees.

Common causes

Newborn care (H001 or H261) billed for a baby who was in the NICU
Two physicians billing different kinds of newborn care for the same days

How to fix it

Check the dates of the neonatal intensive care claims and the newborn care claim.
If the baby was receiving neonatal intensive care, the newborn care line is not payable.
Once neonatal intensive care stops, the usual consultation, assessment and procedure fees apply (critical care per diem listings, J30, note G). Bill those for later care.
If the dates don't overlap and you think the line was refused in error, send an RAI. Send it through eSubmit, or on form 0918-84, within 7 months of the RA date.

Don't resubmit if

The baby was receiving neonatal intensive care on the same days.
The claim is already on your Remittance Advice. 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

Related codes: P2, P3