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K060
K060 – Activities of Daily Living Index of Part B for Medical Review process
OHIP Consultation & Visit Premium Codes Code — APPENDIX F · Schedule of Benefits
This service covers the completion of the 'Activities of Daily Living Index of Part B (completed separately) for Medical Review process'. As detailed on page , this is not an 'insured service' under the Health Insurance Act. Instead, it is paid by the Ministry of Health, which acts as a paying agent on behalf of the Ministry of Children, Community and Social Services (MCCSS) for the Ontario Disability Support Program (ODSP).
When to Use
- Use K060 specifically when completing the Activities of Daily Living Index as part of the formal ODSP medical review process for an existing recipient.
- Use this code when the patient presents with the specific MCCSS-issued medical review package that requires the completion of the ADL Index form.
Common Pitfalls
- Billing K060 for general disability forms or initial ODSP applications, which should be billed under K050 or K051 instead.
- Submitting K060 alongside an office visit code (A007) for the same encounter, which will trigger a rejection as the form completion is a distinct administrative service.
- Failing to ensure the patient is undergoing a formal ODSP medical review, as billing this for non-ODSP related functional assessments is an invalid use of the code.
Billing Tips
- Ensure the claim is submitted with the correct diagnostic code related to the patient's underlying disability to align with the ODSP review documentation.
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