Error code
SE — Major pre-op visit and admission assessment already paid - surgical fee reduced
Admission assessment deducted
Both a major pre-operative visit and an admission assessment were paid, so the surgical fee was reduced by the admission assessment.
What to do: Check the dates of both visits; if the admission assessment was for the surgery, the reduction is correct.
- Code
- SE
- Description
- Major pre-op visit and admission assessment already paid - surgical fee reduced
Explanation
Updated October 26, 2026
SE means both a major pre-op visit and an admission assessment were paid, so the surgical fee was reduced by the admission assessment.
What it means
Code SE means OHIP had already paid both a major pre-operative visit and an admission assessment, so it reduced the surgical fee by the amount of the admission assessment.
A surgeon may not bill the hospital or day care admission assessment unless it is the major pre-operative visit (SP2). When both were paid, OHIP recovers the admission assessment from the surgical fee.
Common causes
- The surgeon billed an admission assessment on top of an earlier major pre-operative visit
How to fix it
- Check the dates of the major pre-operative visit and the admission assessment.
- If the admission assessment was for the surgery, the reduction is correct.
- If the admission was for a different condition, 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