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Y840

Y840Y840

OHIP Other Code · Schedule of Benefits

When to Use

  • Use Y840 as a diagnostic code when billing for the administration of a publicly funded vaccine, such as the seasonal influenza or COVID-19 vaccine, where the service is not covered by a standard office visit fee.
  • Apply this code when submitting claims for immunization services provided under specific public health programs that require a diagnostic indicator for tracking purposes.

Common Pitfalls

  • Do not use Y840 as a primary diagnostic code for a standard office visit (A007) if the patient presents with a specific medical complaint, as this will lead to rejection or audit flags.
  • Avoid using Y840 in conjunction with fee-for-service assessment codes unless the immunization is the sole purpose of the visit, as it may trigger a 'duplicate service' or 'inappropriate diagnostic code' error.

Billing Tips

  • Ensure Y840 is paired with the appropriate administrative fee code (e.g., G538) to ensure the claim is processed correctly under the provincial immunization program.
Provider Fee$0.00
Surgical Assistant Fee$95.70
Non-Anaesthetist Fee$59.74

Effective: April 1, 2026

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