How do I fix OHIP error code SB?

Check which visit OHIP treated as the normal pre-operative visit. If it was routine pre-operative care, the reduction is correct, except for an in-hospital pre-operative assessment by the surgeon 1 to 2 days before surgery from April 1, 2026, which is now paid in full (INFOBulletin 260901). If that visit was the major pre-operative visit (the decision to operate), or was for an unrelated problem, send a Remittance Advice Inquiry (RAI) through eSubmit, or on form 0918-84, within 7 months of the RA date.

When shouldn't I resubmit a SB claim?

The claim is already on your Remittance Advice. Use an RAI, not a new claim.

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Error code

SB — Pre-op visit included in surgical fee - visit already paid, surgical fee adjusted

Q: What does OHIP error code SB mean?

SB means a normal pre-operative visit is included in the surgical fee. The visit was already paid, so the surgical fee was reduced.

Pre-op visit deducted

A routine pre-operative visit, normally part of the surgical fee, was already paid, so the surgical fee was reduced.

What to do: Check which visit was reduced; since April 1, 2026, in-hospital pre-operative assessments 1 to 2 days before surgery are paid in full.

Code: SB
Description: Pre-op visit included in surgical fee - visit already paid, surgical fee adjusted

Explanation

Updated October 26, 2026

SB means a normal pre-operative visit is included in the surgical fee. The visit was already paid, so the surgical fee was reduced.

What it means

Code SB means OHIP had already paid a pre-operative visit that is normally part of the surgical fee, so it reduced the surgical fee to account for it.

The surgical fee includes preparing the patient for the procedure (SP1). Only the major pre-operative visit, where the decision to operate is made, is billed separately. A surgeon may not bill the hospital or day care admission assessment unless it is the major pre-operative visit (SP2).

Common causes

A routine pre-operative visit was billed and paid before the surgery claim was processed
An admission assessment by the surgeon that wasn't the major pre-operative visit

How to fix it

Check which visit OHIP treated as the normal pre-operative visit.
If it was routine pre-operative care, the reduction is correct, except for an in-hospital pre-operative assessment by the surgeon 1 to 2 days before surgery from April 1, 2026, which is now paid in full (INFOBulletin 260901).
If that visit was the major pre-operative visit (the decision to operate), or was for an unrelated problem, send a Remittance Advice Inquiry (RAI) through eSubmit, or on form 0918-84, within 7 months of the RA date.

Don't resubmit if

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: S7, SC, SE