OHIP Diagnostic Codes and Descriptions
OHIP diagnostic codes identify the diagnosis, condition, symptom or reason associated with an insured service submitted on an Ontario Health Insurance Plan claim.
Use this article to search for a three-digit or supplementary diagnostic code and review its description.
How do I search for an OHIP diagnostic code on HYPEMedical?
- Open the Claim Details tab in HYPEMedical (Claim \ Create Claim \ Claim Details).
- Locate the Diagnostic Code field or click on the ? next to Diag. Code
Search using either:
- The diagnostic code, such as 250, 401, 493, or 724
- A diagnosis or symptom, such as diabetes, hypertension, asthma, or back pain
Infections and Parasitic Diseases
Intestinal infectious diseases
| Code | Diagnosis |
|---|
| 002 | Typhoid and paratyphoid fevers |
| 003 | Other salmonella infections |
| 005 | Food poisoning |
| 006 | Amoebiasis or amoebic dysentery |
| 009 | Diarrhea, gastro-enteritis or viral gastroenteritis |
Tuberculosis
| Code | Diagnosis |
| 010 | Primary tuberculous infection, including recent positive TB skin-test conversion |
| 011 | Pulmonary tuberculosis |
| 012 | Other respiratory tuberculosis or tuberculous pleurisy, with or without effusion |
| 015 | Tuberculosis of bones and joints |
| 017 | Tuberculosis of other organs |
Other bacterial diseases
| Code | Diagnosis |
| 023 | Brucellosis |
| 030 | Leprosy or Hansen’s disease |
| 032 | Diphtheria |
| 033 | Whooping cough or pertussis |
| 034 | Streptococcal sore throat or scarlet fever |
| 035 | Erysipelas |
| 036 | Meningococcal infection or meningitis |
| 037 | Tetanus |
| 038 | Septicemia or blood poisoning |
| 039 | Actinomycotic infections |
| 040 | Other bacterial diseases |
Human Immunodeficiency Virus infection
| Code | Diagnosis |
| 042 | AIDS |
| 043 | AIDS-related complex |
| 044 | Other human immunodeficiency virus infection |
Viral diseases of the central nervous system
| Code | Diagnosis |
| 045 | Acute poliomyelitis |
| 047 | Meningitis due to enterovirus |
| 049 | Other non-arthropod-borne viral diseases of the central nervous system |
Viral diseases accompanied by rash
| Code | Diagnosis |
| 052 | Chickenpox |
| 053 | Herpes zoster or shingles |
| 054 | Herpes simplex or cold sore |
| 055 | Measles |
| 056 | German measles or rubella |
| 057 | Other viral disorders accompanied by rash, such as roseola |
Other viral diseases
| Code | Diagnosis |
| 062 | Mosquito-borne viral encephalitis |
| 066 | Other arthropod-borne viral diseases |
| 070 | Viral hepatitis |
| 072 | Mumps |
| 074 | Diseases due to Coxsackie virus, including pleurodynia and myocarditis |
| 075 | Infectious mononucleosis or glandular fever |
| 078 | Warts |
| 079 | Other viral diseases |
| 080 | Coronavirus |
Venereal diseases
| Code | Diagnosis |
| 097 | Syphilis, all sites and stages |
| 098 | Gonococcal infections |
| 099 | Other venereal diseases, including herpes genitalis |
Internal-use diagnostic code
| Code | Diagnosis |
| 100 | Internal-use code used when the service or diagnosis on an incoming claim is requested to be suppressed from verification. Use of this code is monitored. |
Mycoses
| Code | Diagnosis |
| 110 | Ringworm of the scalp, beard or foot |
| 112 | Candidiasis or monilia infection, all sites, including thrush |
| 115 | Histoplasmosis |
| 117 | Other mycoses |
Helminthiases
| Code | Diagnosis |
| 122 | Echinococcosis or hydatid cyst, all sites |
| 123 | Taenia or tapeworm infestation, all types |
| 127 | Pinworm infestation |
| 128 | Other helminthiases |
Other infectious and parasitic diseases
| Code | Diagnosis |
| 130 | Toxoplasmosis |
| 131 | Trichomonas infection |
| 132 | Head or body lice or pediculosis |
| 133 | Scabies or acariasis |
| 135 | Sarcoidosis |
| 136 | Other infectious or parasitic diseases |
Neoplasms
Malignant neoplasms of the lip, mouth and pharynx
| Code | Diagnosis |
| 140 | Lip |
| 141 | Tongue |
| 142 | Major salivary glands |
| 143 | Gum |
| 144 | Floor of mouth |
| 145 | Other and unspecified parts of mouth |
| 146 | Oropharynx |
| 147 | Nasopharynx |
| 148 | Hypopharynx |
| 149 | Other and ill-defined sites within the lip, oral cavity and pharynx |
Malignant neoplasms of digestive organs
| Code | Diagnosis |
| 150 | Esophagus |
| 151 | Stomach |
| 152 | Small intestine, including duodenum |
| 153 | Large intestine, excluding rectum |
| 154 | Rectum, rectosigmoid and anus |
| 155 | Primary malignancy of liver, not secondary spread or metastatic disease |
| 156 | Gallbladder and extrahepatic bile ducts |
| 157 | Pancreas |
| 158 | Retroperitoneum and peritoneum |
| 159 | Other and ill-defined sites within the digestive organs and peritoneum |
Malignant neoplasms of respiratory and intrathoracic organs
| Code | Diagnosis |
| 160 | Nasal cavities, middle ear and accessory sinuses |
| 161 | Larynx or trachea |
| 162 | Bronchus or lung |
| 163 | Pleura |
| 164 | Thymus, heart and mediastinum |
| 165 | Other sites within the respiratory system and intrathoracic organs |
Malignant neoplasms of bone, tissue and skin
| Code | Diagnosis |
| 170 | Bone |
| 171 | Connective and other soft tissue |
| 172 | Melanoma of skin |
| 173 | Other skin malignancies |
Malignant neoplasms of breast and genital organs
| Code | Diagnosis |
| 174 | Female breast |
| 175 | Male breast |
| 179 | Uterus, part unspecified |
| 180 | Cervix |
| 181 | Placenta |
| 182 | Body of uterus |
| 183 | Ovary, fallopian tube or broad ligament |
| 184 | Vagina, vulva or other female genital organs |
| 185 | Prostate |
| 186 | Testis |
| 187 | Other male genital organs |
Malignant neoplasms of urinary, nervous and endocrine systems
| Code | Diagnosis |
| 188 | Bladder |
| 189 | Kidney or other urinary organs |
| 190 | Eye |
| 191 | Brain |
| 192 | Cranial nerves, spinal cord or other parts of the nervous system |
| 193 | Thyroid |
| 194 | Other endocrine glands and related structures |
| 195 | Other ill-defined sites |
Secondary and unspecified malignant neoplasms
| Code | Diagnosis |
| 196 | Secondary neoplasm of lymph nodes |
| 197 | Secondary neoplasm of respiratory and digestive systems |
| 198 | Metastatic or secondary malignant neoplasm or carcinomatosis |
| 199 | Other malignant neoplasms |
| Code | Diagnosis |
| 200 | Lymphosarcoma or reticulosarcoma |
| 201 | Hodgkin’s disease |
| 202 | Other malignant neoplasms of lymphoid and histiocytic tissue |
| 203 | Multiple myeloma or plasma-cell leukemia |
| 204 | Lymphoid leukemia, including lymphatic and histiocytic leukemia |
| 205 | Myeloid leukemia, including granulocytic and myelogenous leukemia |
| 206 | Monocytic leukemia |
| 207 | Other specified leukemia |
| 208 | Other types of leukemia |
Benign neoplasms
| Code | Diagnosis |
| 210 | Lip, oral cavity or pharynx |
| 211 | Other parts of digestive system or peritoneum |
| 212 | Respiratory and intrathoracic organs |
| 213 | Bone or cartilage |
| 214 | Lipoma |
| 215 | Connective and other soft tissue |
| 216 | Skin, including pigmented naevus and dermatofibroma |
| 217 | Breast |
| 218 | Uterine fibroid or leiomyoma |
| 219 | Other benign neoplasms of uterus, including cervical polyp |
| 220 | Ovary, including ovarian cyst |
| 221 | Other benign neoplasms of female genital organs |
| 222 | Male genital organs |
| 223 | Kidney, ureter or bladder |
| 224 | Eye |
| 225 | Brain, spinal cord or peripheral nerves |
| 226 | Thyroid, including adenoma or cystadenoma |
| 227 | Other endocrine glands and related structures |
| 228 | Haemangioma and lymphangiomax |
| 229 | Other benign neoplasms |
Carcinoma in situ
| Code | Diagnosis |
| 230 | Digestive organs |
| 231 | Respiratory system |
| 232 | Skin |
| 233 | Breast and genitourinary system |
| 234 | Other carcinoma in situ |
Neoplasms of uncertain behaviour
| Code | Diagnosis |
| 235 | Digestive and respiratory systems |
| 236 | Genitourinary organs |
| 237 | Endocrine glands and nervous system |
| 238 | Other and unspecified sites and tissues |
| 239 | Unspecified neoplasms, including polycythemia vera |
Thyroid and endocrine-gland disorders
| Code | Diagnosis |
| 240 | Simple thyroid goitre |
| 241 | Nontoxic nodular goitre |
| 242 | Hyperthyroidism, thyrotoxicosis or exophthalmic goitre |
| 243 | Congenital hypothyroidism, including cretinism |
| 244 | Acquired hypothyroidism, including myxedema |
| 245 | Thyroiditis |
| Code | Diagnosis |
| 248 | Diabetes mellitus with ocular complications |
| 249 | Pre-diabetes |
| 250 | Diabetes mellitus, including complications |
| 251 | Other disorders of pancreatic internal secretions, including insulinoma, neonatal hypoglycemia and Zollinger-Ellison syndrome |
| 252 | Parathyroid-gland disorders, including hyperparathyroidism and hypoparathyroidism |
| 253 | Pituitary-gland disorders, including acromegaly, dwarfism and diabetes insipidus |
| 255 | Adrenal-gland disorders, including Cushing’s syndrome, hyperaldosteronism, Conn’s syndrome, adrenogenital syndrome and Addison’s disease |
| 256 | Ovarian dysfunction, including ovarian failure, polycystic ovaries and Stein-Leventhal syndrome |
| 257 | Testicular dysfunction |
| 259 | Other endocrine disorders |
| Code | Diagnosis |
| 263 | Unspecified malnutrition |
| 269 | Vitamin and other nutritional deficiencies |
| 270 | Disorders of amino-acid metabolism, including cystinuria and Fanconi syndrome |
| 272 | Disorders of lipoid metabolism, including hypercholesterolemia and lipoprotein disorders |
| 274 | Gout |
| 277 | Other metabolic disorders |
| 278 | Obesity |
| 279 | Hypogammaglobulinemia, agammaglobulinemia and other immunity disorders |
| Code | Diagnosis |
| 280 | Iron-deficiency anaemia |
| 281 | Pernicious anaemia |
| 282 | Hereditary hemolytic anaemia, including thalassemia and sickle-cell anaemia |
| 283 | Acquired hemolytic anaemia, excluding hemolytic disease of the newborn |
| 284 | Aplastic anaemia |
| 285 | Other anaemias |
| 286 | Coagulation defects, including hemophilia and other factor deficiencies |
| 287 | Purpura, thrombocytopenia and other hemorrhagic conditions |
| 288 | Neutropenia, acranulocytosis or eosinophilia |
| 289 | Other diseases of blood, marrow or spleen |
Mental Disorders
Psychoses
| Code | Diagnosis |
| 290 | Senile dementia or presenile dementia |
| 291 | Alcoholic psychosis, delirium tremens or Korsakov’s psychosis |
| 292 | Drug psychosis |
| 295 | Schizophrenia |
| 296 | Manic-depressive psychosis or involutional melancholia |
| 297 | Paranoid states |
| 298 | Other psychoses |
| 299 | Childhood psychoses, including autism |
Neuroses, personality and behavioural disorders
| Code | Diagnosis |
| 300 | Anxiety neurosis, hysteria, neurasthenia, obsessive-compulsive neurosis or reactive depression |
| 301 | Personality disorders, including paranoid, schizoid and obsessive-compulsive personality |
| 302 | Sexual deviations |
| 303 | Alcoholism |
| 304 | Drug dependence or drug addiction |
| 305 | Tobacco abuse |
| 306 | Psychosomatic disturbances |
| 307 | Habit spasms, tics, stuttering, tension headaches, anorexia nervosa, sleep disorders or enuresis |
| 309 | Adjustment reaction |
| 311 | Depressive or other non-psychotic disorders not elsewhere classified |
| 313 | Behaviour disorders of childhood and adolescence |
| 314 | Hyperkinetic syndrome of childhood |
| 315 | Specified delays in development, including dyslexia, dyslalia and motor retardation |
| 319 | Mental retardation |
Diseases of the Nervous System and Sense Organs
Central nervous system
| Code | Diagnosis |
| 320 | Bacterial meningitis |
| 321 | Meningitis due to other organisms |
| 323 | Encephalitis or encephalomyelitis |
| 330 | Tay-Sachs disease |
| 331 | Other cerebral degenerations |
| 332 | Parkinson’s disease |
| 335 | Anterior Horn Cell Disease |
| 340 | Multiple sclerosis |
| 343 | Cerebral palsy |
| 345 | Epilepsy |
| 346 | Migraine |
| 349 | Other diseases of the central nervous system, including brain abscess, narcolepsy, motor-neuron disease and syringomyelia |
Peripheral nervous system
| Code | Diagnosis |
| 350 | Trigeminal neuralgia or tic douloureux |
| 351 | Bell’s palsy or facial-nerve disorders |
| 352 | Disorders of other cranial nerves |
| 356 | Idiopathic peripheral neuritis |
| 358 | Myoneural disorders, including myasthenia gravis |
| 359 | Muscular dystrophies |
Eye disorders
| Code | Diagnosis |
| 360 | Aphakia |
| 361 | Retinal detachment |
| 362 | Hypertensive retinopathy and other retinal diseases not specifically listed |
| 363 | Chorioretinitis |
| 364 | Iritis |
| 365 | Glaucoma |
| 366 | Cataract, excluding diabetic or congenital cataract |
| 367 | Myopia, astigmatism, presbyopia and other disorders of refraction and accommodation, excluding conditions under code 371 |
| 368 | Amblyopia or visual-field defects |
| 369 | Blindness and low vision |
| 370 | Keratitis or corneal ulcer |
| 371 | High myopia greater than nine diopters or irregular astigmatism resulting from corneal grafting or corneal scarring from disease |
| 372 | Conjunctiva disorders, including conjunctivitis and pterygium |
| 373 | Blepharitis, chalazion or stye |
| 374 | Other eyelid disorders, including entropion, ectropion and ptosis |
| 375 | Dacryocystitis or obstruction of the lacrimal duct |
| 376 | Keratoconus |
| 377 | Optic neuritis |
| 378 | Strabismus |
| 379 | Other disorders of the eye |
| 972 | Recurrent uveitis |
| 976 | Poisoning by eye anti-infectives and other eye drugs |
Ear and mastoid disorders
| Code | Diagnosis |
| 380 | Otitis externa |
| 381 | Serous otitis media or eustachian-tube disorders |
| 382 | Suppurative otitis media |
| 383 | Mastoiditis |
| 384 | Perforation of tympanic membrane |
| 386 | Meniere’s disease or labyrinthitis |
| 387 | Otosclerosis |
| 388 | Wax or cerumen in ear, tinnitus or other disorders of ear and mastoid |
| 389 | Deafness |
Neurological signs and symptoms not yet diagnosed
| Code | Diagnosis |
| 780 | Convulsions, ataxia, vertigo or headache, excluding tension headache and migraine |
Diseases of the Circulatory System
Rheumatic fever and rheumatic heart disease
| Code | Diagnosis |
| 390 | Rheumatic fever without endocarditis, myocarditis or pericarditis |
| 391 | Rheumatic fever with endocarditis, myocarditis or pericarditis |
| 392 | Chorea |
| 394 | Mitral stenosis or mitral insufficiency |
| 398 | Other rheumatic heart disease |
Hypertensive disease
| Code | Diagnosis |
| 401 | Essential or benign hypertension |
| 402 | Hypertensive heart disease |
| 403 | Hypertensive renal disease |
Ischaemic and other heart disease
| Code | Diagnosis |
| 410 | Acute myocardial infarction |
| 412 | Old myocardial infarction or chronic coronary artery disease without symptoms |
| 413 | Acute coronary insufficiency, angina pectoris or acute ischaemic heart disease |
| 415 | Pulmonary embolism or pulmonary infarction |
| 426 | Heart blocks or other conduction disorders |
| 427 | Paroxysmal tachycardia, atrial or ventricular flutter or fibrillation, cardiac arrest or other arrhythmias |
| 428 | Congestive heart failure |
| 429 | All other forms of heart disease |
Cerebrovascular disease
| Code | Diagnosis |
| 432 | Intracranial haemorrhage |
| 435 | Transient cerebral ischaemia |
| 436 | Acute cerebrovascular accident, CVA or stroke |
| 437 | Chronic arteriosclerotic cerebrovascular disease or hypertensive encephalopathy |
Diseases of arteries
| Code | Diagnosis |
| 440 | Generalized arteriosclerosis or atherosclerosis |
| 441 | Aortic aneurysm, non-syphilitic |
| 443 | Raynaud’s disease, Buerger’s disease, peripheral vascular disease or intermittent claudication |
| 446 | Polyarteritis nodosa or temporal arteritis |
| 447 | Other disorders of arteries |
Diseases of veins and lymphatics
| Code | Diagnosis |
| 451 | Phlebitis or thrombophlebitis |
| 452 | Portal-vein thrombosis |
| 454 | Varicose veins of the lower extremities, with or without ulcer |
| 455 | Haemorrhoids |
| 457 | Lymphangitis or lymphedema |
| 459 | Other disorders of the circulatory system |
Circulatory signs and symptoms not yet diagnosed
| Code | Diagnosis |
| 785 | Chest pain, tachycardia, syncope, shock, edema or masses |
Diseases of the Respiratory System
| Code | Diagnosis |
| 460 | Acute nasopharyngitis or common cold |
| 461 | Acute sinusitis |
| 463 | Acute tonsillitis |
| 464 | Acute laryngitis, tracheitis, croup or epiglottis |
| 466 | Acute bronchitis |
| 470 | Deviated nasal septum |
| 471 | Nasal polyp |
| 473 | Chronic sinusitis |
| 474 | Hypertrophy or chronic infection of tonsils and/or adenoids |
| 477 | Allergic rhinitis or hay fever |
| 486 | Pneumonia, all types |
| 487 | Influenza |
| 491 | Chronic bronchitis |
| 492 | Emphysema |
| 493 | Asthma or allergic bronchitis |
| 494 | Bronchiectasis |
| 496 | Other chronic obstructive pulmonary disease |
| 501 | Asbestosis |
| 502 | Silicosis |
| 511 | Pleurisy, with or without effusion |
| 512 | Spontaneous or tension pneumothorax |
| 515 | Pulmonary fibrosis |
| 518 | Atelectasis or other diseases of lung |
| 519 | Other diseases of the respiratory system |
| 786 | Epistaxis, hemoptysis, cough, dyspnea, masses, shortness of breath, hyperventilation or sleep apnea |
Diseases of the Digestive System
Oral cavity, salivary glands and jaws
| Code | Diagnosis |
| 521 | Dental caries and other diseases of hard tissues of teeth; system-inserted for dentists’ claims |
| 523 | Gingivitis or periodontal disease |
| 524 | Prognathism, micrognathism, macrognathism, retrognathism, malocclusion or temporomandibular-joint disorders |
| 525 | Other conditions of teeth and supporting structure |
| 527 | Disease of salivary glands |
| 528 | Stomatitis, aphthous ulcers, canker sore or diseases of lips |
| 529 | Glossitis or other conditions of the tongue |
Esophagus, stomach and duodenum
| Code | Diagnosis |
| 530 | Esophagitis, cardiospasm, ulcer, stricture, stenosis or obstruction of esophagus |
| 531 | Gastric ulcer, with or without haemorrhage or perforation |
| 532 | Duodenal ulcer, with or without haemorrhage or perforation |
| 534 | Stomal or gastrojejunal ulcer |
| 535 | Gastritis |
| 536 | Hyperchlorhydria, hypochlorhydria, dyspepsia or indigestion |
| 537 | Other disorders of stomach and duodenum |
| 545 | Colon positive fecal occult blood |
| 546 | Colon surveillance |
| 547 | Family history of colon cancer |
| 548 | Colon screening |
Hernia
| Code | Diagnosis |
| 550 | Inguinal hernia, with or without obstruction |
| 552 | Femoral, umbilical, ventral, diaphragmatic or hiatus hernia with obstruction |
| 553 | Femoral, umbilical, ventral, diaphragmatic or hiatus hernia without obstruction |
Intestine and peritoneum
| Code | Diagnosis |
| 540 | Acute appendicitis, with or without abscess or peritonitis |
| 555 | Regional enteritis or Crohn’s disease |
| 556 | Ulcerative colitis |
| 557 | Mesenteric-artery occlusion or other vascular conditions of intestine |
| 560 | Intestinal obstruction, intussusception, paralytic ileus, volvulus or impaction |
| 562 | Diverticulitis or diverticulosis of large or small intestine |
| 564 | Spastic colon, irritable colon, mucous colitis or constipation |
| 565 | Anal fissure or anal fistula |
| 566 | Abscess of anal or rectal regions |
| 567 | Peritonitis, with or without abscess |
| 569 | Anal or rectal polyp, prolapse, stricture, rectal bleeding or other intestinal disorder |
Other diseases of the digestive system
| Code | Diagnosis |
| 571 | Cirrhosis of liver, including alcoholic and biliary cirrhosis |
| 573 | Other diseases of liver |
| 574 | Cholelithiasis or gallstones, with or without cholecystitis |
| 575 | Cholecystitis without gallstones |
| 576 | Other diseases of gallbladder and biliary ducts |
| 577 | Diseases of pancreas |
| 579 | Malabsorption syndrome, sprue or celiac disease |
| 787 | Anorexia, nausea, vomiting, heartburn, dysphagia, hiccough, hematemesis, jaundice, ascites, abdominal pain, melena or masses |
Diseases of the Genitourinary System
Urinary system
| Code | Diagnosis |
| 580 | Acute glomerulonephritis |
| 581 | Nephrotic syndrome |
| 584 | Acute renal failure |
| 585 | Chronic renal failure or uremia |
| 590 | Acute or chronic pyelonephritis, pyelitis or abscess |
| 591 | Hydronephrosis |
| 592 | Stone in kidney or ureter |
| 593 | Other disorders of kidney or ureter |
| 595 | Cystitis |
| 597 | Non-specific urethritis not sexually transmitted |
| 598 | Urethral stricture |
| 599 | Other disorders of urinary tract |
Male genital organs
| Code | Diagnosis |
| 600 | Benign prostatic hypertrophy |
| 601 | Prostatitis |
| 603 | Hydrocele |
| 604 | Orchitis or epididymitis |
| 605 | Phimosis or paraphimosis |
| 606 | Male infertility, oligospermia or azoospermia |
| 608 | Seminal vesiculitis, spermatocele, torsion, undescended testicle or other disorders |
| 609 | Newborn circumcision |
Breast and female pelvic organs
| Code | Diagnosis |
| 610 | Cystic mastitis, chronic cystic disease, breast cyst or fibro-adenosis |
| 611 | Breast abscess, gynecomastia, hypertrophy or other breast disorders |
| 614 | Acute or chronic salpingitis, oophoritis, abscess or pelvic inflammatory disease |
| 615 | Acute or chronic endometritis |
| 616 | Cervicitis, vaginitis, Bartholin’s-gland cyst or abscess, or vulvitis |
| 617 | Endometriosis |
| 618 | Cystocele, rectocele, urethrocele, enterocele or uterine prolapse |
| 621 | Retroversion of uterus, endometrial hyperplasia or other disorders of uterus |
| 622 | Cervical erosion or cervical dysplasia |
| 623 | Stricture or stenosis of vagina |
| 625 | Dyspareunia, dysmenorrhea, premenstrual tension or stress incontinence |
| 626 | Disorders of menstruation |
| 627 | Menopause or postmenopausal bleeding |
| 628 | Infertility |
| 629 | Other disorders of female genital organs |
| 788 | Renal colic, urinary retention, nocturia or masses |
Complications of Pregnancy, Childbirth and the Puerperium
| Code | Diagnosis |
| 632 | Missed abortion |
| 633 | Ectopic pregnancy |
| 634 | Incomplete or complete abortion |
| 635 | Therapeutic abortion |
| 640 | Threatened abortion or haemorrhage in early pregnancy |
| 641 | Abruptio placentae or placenta praevia |
| 642 | Pre-eclampsia, eclampsia or toxaemia |
| 643 | Vomiting or hyperemesis gravidarum |
| 644 | False labour or threatened labour |
| 645 | Prolonged pregnancy |
| 646 | Other pregnancy complications, including vulvitis, vaginitis, cervicitis, pyelitis and cystitis |
| 650 | Normal delivery or uncomplicated pregnancy |
| 651 | Multiple pregnancy |
| 652 | Unusual fetal position or malpresentation |
| 653 | Cephalo-pelvic disproportion |
| 656 | Foetal distress |
| 658 | Premature rupture of membrane |
| 660 | Obstructed labour |
| 661 | Uterine inertia |
| 662 | Prolonged labour |
| 664 | Perineal lacerations |
| 666 | Postpartum haemorrhage |
| 667 | Retained placenta |
| 669 | Delivery with other complications |
| 671 | Postpartum thrombophlebitis |
| 675 | Postpartum mastitis or nipple infection |
| 677 | Postpartum pulmonary |
Diseases of the Skin and Subcutaneous Tissue
Infections
| Code | Diagnosis |
| 680 | Boil, carbuncle or furunculosis |
| 682 | Cellulitis or abscess |
| 683 | Acute lymphadenitis |
| 684 | Impetigo |
| 685 | Pilonidal cyst or abscess |
| 686 | Pyoderma, pyogenic granuloma or other local infection |
Inflammatory conditions
| Code | Diagnosis |
| 690 | Seborrheic dermatitis |
| 691 | Eczema, atopic dermatitis or neurodermatitis |
| 692 | Contact dermatitis |
| 695 | Erythema multiforme, erythema nodosum, acne, rosacea, lupus erythematosus or intertrigo |
| 696 | Psoriasis |
| 698 | Pruritus ani or other itchy conditions |
Other skin and subcutaneous disorders
| Code | Diagnosis |
| 700 | Corns or calluses |
| 701 | Hyperkeratosis, scleroderma or keloid |
| 703 | Ingrown nail or onychogryposis |
| 704 | Alopecia |
| 706 | Acne, acne vulgaris or sebaceous cyst |
| 707 | Decubitus ulcer or bed sore |
| 708 | Allergic urticaria |
| 709 | Other disorders of skin and subcutaneous tissue |
Diseases of the Musculoskeletal System and Connective Tissue
| Code | Diagnosis |
| 710 | Disseminated lupus erythematosus, generalized scleroderma, dermatomyositis or polymyositis |
| 711 | Pyogenic arthritis |
| 714 | Rheumatoid arthritis or Still’s disease |
| 715 | Osteoarthritis |
| 716 | Traumatic arthritis |
| 718 | Joint derangement, recurrent dislocation, ankylosis, meniscus or cartilage tear, or loose body in joint |
| 720 | Ankylosing spondylitis |
| 721 | Sero-negative spondyloarthropathies |
| 722 | Intervertebral-disc disorders |
| 724 | Lumbar strain, lumbago, coccydynia or sciatica |
| 725 | Polymyalgia rheumatic |
| 726 | Fibromyalgia |
| 727 | Synovitis, tenosynovitis, bursitis, bunion or ganglion |
| 728 | Dupuytren’s contracture |
| 729 | Fibrositis, myositis or muscular rheumatism |
| 730 | Osteomyelitis |
| 731 | Osteitis deformans or Paget’s disease of bone |
| 732 | Osteochondritis, Legg-Perthes disease, Osgood-Schlatter disease or osteochondritis dissecans |
| 733 | Osteoporosis, spontaneous fracture or other disorders of bone and cartilage |
| 734 | Flat foot or pes planus |
| 735 | Hallux valgus, hallux varus or hammer toe |
| 737 | Scoliosis, kyphosis or lordosis |
| 739 | Other diseases of the musculoskeletal system and connective tissue |
| 781 | Leg cramps, leg pain, muscle pain, joint pain, arthralgia, joint swelling or masses |
Congenital Anomalies
| Code | Diagnosis |
| 741 | Spina bifida, with or without hydrocephalus, meningocele or meningomyelocele |
| 742 | Hydrocephalus |
| 743 | Congenital anomalies of eye |
| 744 | Congenital anomalies of ear, face and neck |
| 745 | Transposition of great vessels, tetralogy of Fallot, ventricular septal defect or atrial septal defect |
| 746 | Other congenital anomalies of heart |
| 747 | Patent ductus arteriosus, coarctation of aorta, pulmonary-artery stenosis or other circulatory anomaly |
| 748 | Congenital anomalies of nose and respiratory system |
| 749 | Cleft palate or cleft lip |
| 750 | Other congenital anomalies of mouth, esophagus, stomach and pylorus |
| 751 | Congenital anomalies of digestive system |
| 752 | Congenital anomalies of genital organs |
| 753 | Congenital anomalies of urinary system |
| 754 | Club foot |
| 755 | Other congenital anomalies of limbs |
| 756 | Other musculoskeletal anomalies |
| 758 | Chromosomal anomalies, including Down’s, Klinefelter’s and Turner’s syndromes |
| 759 | Other congenital anomalies |
Perinatal Morbidity and Mortality
| Code | Diagnosis |
| 762 | Compression or prolapse of umbilical cord |
| 763 | Condition due to complications of labour or delivery |
| 765 | Prematurity or low-birth-weight infant |
| 766 | Postmaturity or high-birth-weight infant |
| 767 | Birth trauma |
| 769 | Hyaline-membrane disease or respiratory-distress syndrome |
| 773 | Hemolytic disease of newborn |
| 777 | Perinatal disorders of digestive system |
| 779 | Other conditions of fetus or newborn |
Symptoms, Signs and Ill-Defined Conditions
| Code | Diagnosis |
| 790 | Non-specific findings on examination of blood |
| 791 | Non-specific findings on examination of urine |
| 795 | Chronic fatigue syndrome |
| 796 | Other non-specific abnormal findings |
| 797 | Senility or senescence |
| 798 | Sudden death, cause unknown |
| 799 | Other ill-defined conditions |
| 780 | Ataxia |
| 781 | Arthralgia |
Accidents, Poisonings and Violence
Fractures and fracture-dislocations
| Code | Diagnosis |
| 802 | Facial bones |
| 803 | Skull |
| 805 | Vertebral column without spinal-cord damage |
| 806 | Vertebral column with spinal-cord damage |
| 807 | Ribs |
| 808 | Pelvis |
| 810 | Clavicle |
| 812 | Humerus |
| 813 | Radius and/or ulna |
| 814 | Carpal bones |
| 815 | Metacarpals |
| 816 | Phalanges of foot or hand |
| 821 | Femur |
| 823 | Tibia and/or fibula |
| 824 | Ankle |
| 829 | Other fractures |
Dislocations
| Code | Diagnosis |
| 831 | Shoulder |
| 832 | Elbow |
| 834 | Finger |
| 839 | Other dislocations |
Sprains, strains and other trauma
| Code | Diagnosis |
| 840 | Shoulder or upper arm |
| 842 | Wrist, hand or fingers |
| 844 | Knee or leg |
| 845 | Ankle, foot or toes |
| 847 | Neck, low back or coccyx |
| 848 | Other sprains and strains |
| 850 | Concussion |
| 854 | Other head injuries |
| 869 | Internal injuries to organs |
| 879 | Lacerations or open wounds, excluding limbs |
| 884 | Lacerations, open wounds or traumatic amputations of upper limbs |
| 894 | Lacerations, open wounds or traumatic amputations of lower limbs |
| 918 | Automated Visual Field test |
| 919 | Abrasions, bruises, contusions or other superficial injuries, including non-venomous bites |
| 930 | Foreign body in eye or other tissues |
| 949 | Thermal or chemical burns |
| 959 | Other injuries or trauma |
Adverse effects
| Code | Diagnosis |
| 977 | Adverse effects of drugs and medications, including allergy, overdose and reactions |
| 989 | Adverse effects of other chemicals, including lead, pesticides and venomous bites |
| 994 | Adverse effects of physical factors, including heat, cold, frostbite and pressure |
| 995 | Anaphylaxis |
| 998 | Adverse effects of surgical or medical care, including wound infection, wound disruption and other iatrogenic disease |
Supplementary Classifications
Family planning and immunization
| Code | Diagnosis |
| 895 | Family planning, contraceptive advice or advice concerning sterilization or abortion |
| 896 | Immunization, all types |
| 960 | Pentavalent, DPT POLIO/ACT HIB |
| 961 | DPT Polio |
| 962 | DT |
| 963 | MMR: measles, mumps and rubella |
| 964 | Hepatitis B |
| 965 | TD Polio |
| 966 | TD for adults and patients aged seven years and older |
| 967 | Influenza |
| 968 | Pneumococcal |
| 969 | Other immunization not defined |
Social, marital and family problems
| Code | Diagnosis |
| 897 | Economic problems |
| 898 | Marital difficulties |
| 899 | Parent-child problems, including child abuse, battered child and child neglect |
| 900 | Problems with aged parents or in-laws |
| 901 | Family disruption or divorce |
| 902 | Educational problems |
| 903 | Illegitimacy |
| 904 | Social maladjustment |
| 905 | Occupational problems, unemployment or difficulty at work |
| 906 | Legal problems, litigation or imprisonment |
| 909 | Other problems of social adjustment |
Other supplementary codes
| Code | Diagnosis |
| 916 | Well-baby care |
| 917 | Annual adolescent or adult health examination or well-vision care |
Supplementary Physiotherapy Classifications
Operations on the musculoskeletal system
| Code | Diagnosis |
| 893 | Osteotomy |
| 894 | Excision of bunion |
| 897 | Partial excision of bone |
| 898 | Complete excision of bone, including patellectomy |
| 923 | Excision or destruction of intervertebral disc or excision of semilunar cartilage of knee |
| 924 | Synovectomy |
| 930 | Spinal fusion |
| 931 | Arthrodesis of foot and ankle |
| 932 | Arthrodesis of other joints |
| 933 | Arthroplasty of foot and toe |
| 934 | Arthroplasty of knee and ankle, including Hauser repair |
| 935 | Total hip replacement |
| 936 | Other arthroplasty of hip |
| 940 | Incision of muscle, tendon, fascia or bursa of hand |
| 941 | Division of muscle, tendon or fascia of hand |
| 944 | Suture of muscle, tendon or fascia of hand |
| 945 | Transplantation of muscle or tendon of hand |
Other acceptable physiotherapy diagnoses
| Code | Diagnosis |
| 072 | Gait training or crutch-walking instruction, acceptable for one treatment visit only |
| 070 | Perceptual-motor testing or assessment of dysfunction |
| 970 | Prenatal care |
| 971 | Postpartum observation |
Some supplementary physiotherapy codes duplicate three-digit codes used elsewhere in the general diagnostic-code list. Interpret them within the applicable physiotherapy classification and billing context.
Supplementary Common Diagnostic Codes
The source also includes the following four-digit common diagnostic codes.
| Code | Diagnosis |
| 7159 | Osteo-degenerative arthritis |
| 7210 | Cervical arthritis |
| 7120 | Gouty arthritis |
| 7149 | Rheumatic arthritis |
| 7169 | Non-specified acute arthritis |
| 7150 | Non-specified chronic arthritis |
| 3510 | Bell’s palsy |
| 7310 | Bursitis |
| 7267 | Calcaneal spur |
| 7269 | Calcaneal bone |
| 7278 | Calcium in bursa |
| 7198 | Calcium in joint |
| 7260 | Capsulitis |
| 7224 | Cervical-disc disease |
| 8470 | Cervical strain |
| 5199 | Chest disease |
| 7177 | Chondromalacia |
| 7220 | Compression fracture, cervical |
| 9241 | Contusion of knee |
| 8310 | Dislocated shoulder |
| 7263 | Epicondylitis |
| 7290 | Fibrositis |
| 7260 | Frozen shoulder |
| 8248 | Closed fracture of ankle |
| 8122 | Unspecified fracture of humerus |
| 8270 | Fracture of leg |
| 8058 | Fracture of vertebra |
| 8140 | Fracture of wrist |
| 2740 | Gout |
| 8409 | Hamstring tendon |
| 7840 | Headache |
| 9593 | Elbow injury |
| 9592 | Shoulder injury |
| 7371 | Acquired kyphosis |
| 7242 | Lumbago |
| 7251 | Degenerative lumbar-disc disease |
| 8472 | Lumbar strain |
| 4579 | Lymphedema |
| 7288 | Muscle spasm |
| 8489 | Muscle strain |
| 7291 | Myositis, plain and trauma |
| 7292 | Unspecified neuralgia |
| 7310 | Paget’s disease |
| 7295 | Arch pain |
| 7245 | Posterior back pain |
| 7242 | Low-back pain |
| 7231 | Neck pain |
| 7287 | Plantar fasciitis |
| 6142 | Pelvic inflammatory disease or salpingitis |
| 4439 | Peripheral vascular disease |
| 7290 | Muscular rheumatism |
| 8439 | Sacroiliac strain or hip strain |
| 7379 | Unspecified scoliosis |
| 7561 | Spondylolisthesis |
| 8450 | Ankle strain |
| 8419 | Elbow strain |
| 8439 | Hip strain |
| 8449 | Knee and leg strain |
| 8421 | Metacarpal strain |
| 8409 | Shoulder strain |
| 8449 | Shin splints |
| 7235 | Stiff neck |
| 7270 | Synovitis |
| 8481 | Temporomandibular strain or sprain |
| 7269 | Tendinitis |
| 7263 | Tennis elbow |
| 8471 | Thoracic strain |
| 8404 | Torn rotator cuff |
| 8470 | Torticollis |
| 8408 | Trapezius sprain |
| 8470 | Whiplash injury |
Frequently Asked Questions
What is an OHIP diagnostic code?
An OHIP diagnostic code identifies the diagnosis, symptom, condition or reason associated with an insured service submitted on an OHIP claim.
Where do I enter the diagnostic code in HYPEMedical?
Enter the applicable code in the Diagnostic Code field on the claim. The code selected should reflect the physician’s documentation and be appropriate for the service being billed.
Which OHIP diagnostic code is used for diabetes?
Common diabetes-related codes include:
- 248: Diabetes mellitus with ocular complications
- 249: Pre-diabetes
- 250: Diabetes mellitus, including complications
Which diagnostic code is used for hypertension?
- 401: Essential or benign hypertension
- 402: Hypertensive heart disease
- 403: Hypertensive renal disease
Which diagnostic code is used for asthma?
493 is used for asthma or allergic bronchitis.
Which diagnostic code is used for pneumonia?
486 is used for pneumonia, all types.
Which diagnostic code is used for a common cold?
460 is used for acute nasopharyngitis or the common cold.
Which diagnostic code is used for anxiety?
300 includes anxiety neurosis and related non-psychotic conditions.
Which diagnostic code is used for depression?
311 is used for depressive or other non-psychotic disorders not elsewhere classified.
The source also includes reactive depression within 300.
Which diagnostic code is used for migraine?
346 is used for migraine.
Which diagnostic code is used for headache?
The source includes:
- 780: Headache among neurological signs and symptoms not yet diagnosed
- 7840: Headache in the supplementary common diagnostic-code list
- 307: Tension headaches among neuroses and personality disorders
The code selected should reflect the documented diagnosis and the applicable billing context.
Which diagnostic code is used for chest pain?
785 includes chest pain, tachycardia, syncope, shock, edema and masses.
Which diagnostic code is used for abdominal pain?
787 includes abdominal pain and other digestive symptoms not yet diagnosed.
Which diagnostic code is used for back pain?
The source includes:
- 724: Lumbar strain, lumbago, coccydynia or sciatica
- 7242: Low-back pain or lumbago
- 7245: Posterior back pain
- 781: Muscle or joint pain among undiagnosed signs and symptoms
Which diagnostic code is used for osteoarthritis?
- 715: Osteoarthritis
- 7159: Osteo-degenerative arthritis in the supplementary common-code list
Which diagnostic code is used for rheumatoid arthritis?
- 714: Rheumatoid arthritis or Still’s disease
- 7149: Rheumatic arthritis in the supplementary common-code list
Which diagnostic code is used for a urinary tract condition?
Common urinary-system codes include:
- 590: Pyelonephritis or pyelitis
- 592: Kidney or ureter stone
- 595: Cystitis
- 597: Non-specific urethritis
- 599: Other urinary-tract disorders
- 788: Renal colic, urinary retention, nocturia or masses
Which diagnostic code is used for pregnancy?
Pregnancy-related codes include:
- 640: Threatened abortion
- 642: Pre-eclampsia or eclampsia
- 643: Hyperemesis gravidarum
- 650: Normal delivery or uncomplicated pregnancy
- 651: Multiple pregnancy
- 970: Prenatal care in the supplementary physiotherapy classification
Which diagnostic code is used for well-baby care?
916 is used for well-baby care.
Which diagnostic code is used for immunization?
- 896: Immunization, all types
- 960–969: Specific supplementary immunization codes
Which diagnostic code is used for influenza vaccination?
967 is used for influenza immunization.
Do not confuse this with 487, which is the diagnosis code for influenza.
Which diagnostic code is used for coronavirus?
080 is listed as Coronavirus.
Which diagnostic code is used for obesity?
278 is used for obesity.
Which diagnostic code is used for COPD?
496 is used for other chronic obstructive pulmonary disease.
Which diagnostic code is used for congestive heart failure?
428 is used for congestive heart failure.
Which diagnostic code is used for stroke?
436 is used for acute cerebrovascular accident, CVA or stroke.
Which diagnostic code is used for a fracture?
Fracture codes depend on the anatomical site. Examples include:
- 803: Skull
- 807: Ribs
- 810: Clavicle
- 812: Humerus
- 813: Radius or ulna
- 821: Femur
- 823: Tibia or fibula
- 824: Ankle
- 829: Other fracture
Which diagnostic code is used for a sprain or strain?
Examples include:
- 840: Shoulder or upper arm
- 842: Wrist, hand or fingers
- 844: Knee or leg
- 845: Ankle, foot or toes
- 847: Neck, low back or coccyx
- 848: Other sprains and strains
Why are some codes repeated?
The source contains:
- General three-digit OHIP diagnostic codes
- Supplementary physiotherapy classifications
- Supplementary four-digit common diagnostic codes
A code may therefore appear more than once with a different description or context. Select the code according to the applicable claim type and billing requirements.
Can any diagnostic code be used with any Fee Schedule Code?
No. A diagnostic code may be valid in the diagnostic-code list but still be unacceptable with a particular Fee Schedule Code.
An incompatible combination may result in an OHIP validation or payment message such as:
- V30: Fee Schedule Code and diagnostic-code combination is not a benefit
- DX: Diagnostic code is not eligible with the Fee Schedule Code
Does HYPEMedical choose the diagnosis for the physician?
No. The physician or authorized billing user remains responsible for selecting a diagnostic code that accurately reflects the clinical documentation and the service submitted.
