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K900

K900K900

OHIP Consultation & Visit Premium Codes Code · Schedule of Benefits

When to Use

  • Use K900 for the initial assessment and management of a patient with a confirmed diagnosis of diabetes mellitus, provided the visit duration is at least 20 minutes.
  • Apply this code for a comprehensive annual review of a diabetic patient's management plan, including medication adjustment and lifestyle counseling, when A007 is insufficient to cover the complexity of the visit.

Common Pitfalls

  • Billing K900 on the same day as a general assessment (A001/A007) for the same patient is a common rejection unless the services are distinct and clearly documented as separate encounters.
  • Failing to meet the mandatory 20-minute time threshold for the service will trigger an audit or rejection, as K900 is a time-based code.

Billing Tips

  • Ensure the clinical note explicitly states the start and end times of the encounter to justify the K900 claim during an audit.
  • If the patient requires additional counseling beyond the K900 scope, consider adding K013 for diabetes education if the specific criteria for that code are met.
Provider Fee$61.20

Effective: April 1, 2025

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