Rejection Code V09/V16


I have been getting many rejections with the code 

V09 Referring health care provider not six numerics
V16 not numeric
These patients came for routine eye exams without refferal necessary.The
MOH tells me that the problem is with your computer program and you say to
resubmit.I resubmit and get the same rejection again.
See for example patient R  submitted for service Sept
11 rejected and resubmitted AGAIN REJECTED
Looking forward to an immediate resolution


Hi D,

V409A does not require a referral. Sometimes MoH uses the wrong rejection code.

As we stated before, your claims are most likely being rejected for V16 - unacceptable diagnostic code. Please refer to the OHIP Schedule of Benefits for Optometry for more details and/or contact your claim assessor for advice.


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