How do I fix OHIP error code V20?

Check the patient's date of birth and age on the service date. For a well-child visit after age 2, bill the code that fits the visit, such as the age-appropriate periodic health visit or an assessment with a suitable diagnostic code. For a patient under 16, don't pair A003 with 917; use the code and diagnostic code that fit the patient's age and the reason for the visit. If the date of birth or health number was wrong, correct it. Resubmit the corrected claim. Resubmit within three months of the service date if you can. If that window has passed but the claim was first submitted on time, use the Ministry's stale-dated resubmission process: one stale-dated claim file through MCEDT, then an email to ClaimsManagement@ontario.ca with the Error Reports showing the original submission date.

When shouldn't I resubmit a V20 claim?

You haven't changed the fee code, diagnostic code or patient details. The same combination will reject again.

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Error code

V20 — Diagnostic code not valid for patient's age

Q: What does OHIP error code V20 mean?

V20 means the diagnostic code doesn't fit the patient's age, usually well-baby dx 916 after age 2 or dx 917 on A003 under 16.

Diagnosis doesn't fit age

The diagnostic code doesn't fit the patient's age, usually well-baby dx 916 after age 2 or dx 917 on A003 under 16.

What to do: Check the patient's age on the service date and bill the code that fits, such as an age-appropriate periodic health visit.

Code: V20
Description: Diagnostic code not valid for patient's age

Explanation

Updated October 26, 2026

V20 means the diagnostic code doesn't fit the patient's age, usually well-baby dx 916 after age 2 or dx 917 on A003 under 16.

What it means

The Ministry describes V20 as an unacceptable age for the diagnostic code. Its rejection conditions name two cases. The first is A007 billed with diagnostic code 916 (well baby care) for a patient over 2 years old. The second is A003 billed with diagnostic code 917 (annual health examination, adolescent or adult) for a patient under 16.

Well baby care is defined as a periodic assessment of a well newborn or infant during the first two years of life. Once a child turns 2, a routine check-up is usually billed as a periodic health visit instead (K017 for a child aged 2 to 15).

Common causes

Well-baby billing pattern (A007 + 916) kept after the child's second birthday
Adult annual-exam pattern (A003 + 917) used for a child or young teen
Wrong date of birth or health number, making the patient look older or younger

How to fix it

Check the patient's date of birth and age on the service date.
For a well-child visit after age 2, bill the code that fits the visit, such as the age-appropriate periodic health visit or an assessment with a suitable diagnostic code.
For a patient under 16, don't pair A003 with 917; use the code and diagnostic code that fit the patient's age and the reason for the visit.
If the date of birth or health number was wrong, correct it.
Resubmit the corrected claim. Resubmit within three months of the service date if you can. If that window has passed but the claim was first submitted on time, use the Ministry's stale-dated resubmission process: one stale-dated claim file through MCEDT, then an email to [email protected] with the Error Reports showing the original submission date.

Don't resubmit if

You haven't changed the fee code, diagnostic code or patient details. The same combination will reject again.

How APEX handles it

APEX treats V20 as a diagnostic code error. It keeps the fee codes as billed and replaces the diagnostic code using the patient's age on the service date: 916 (well baby care) under 2, otherwise 917. You can review the claim first, or let auto-fix send it if you've turned that on. See how APEX works · Pricing

Related codes: A2A, V22, V21, VH8