Q014A – Newborn Care Episodic Fee
OHIP Critical Care Code — APPENDIX Q · Schedule of Benefits
Counselling of relatives on behalf of a catastrophically or terminally ill patient is counselling rendered to a relative or relatives or representative of a catastrophically or terminally ill patient, for the purpose of developing an awareness of modalities for treatment of the patient and/or his or her prognosis, as per . The claim must be submitted under the health number of the patient who is catastrophically or terminally ill. As a counselling service, it is subject to the specific elements outlined in , and the time unit calculations described in , requiring a minimum of 20 minutes of direct contact for the first unit of service.
When to Use
- Use Q014A when providing extended counselling to family members regarding the prognosis or treatment plan of a patient in a terminal state, specifically when the service occurs outside of a standard office setting.
- Use this code instead of a standard K014A when the counselling session is performed in a non-professional setting, such as a patient's home or a long-term care facility, to account for the specific Q-prefix requirements.
Common Pitfalls
- Billing Q014A on the same day as an assessment or consultation for the same patient will trigger an automatic rejection unless you provide a distinct diagnosis code for the counselling service.
- Failing to meet the mandatory 20-minute minimum duration will result in a rejection, as this code is strictly time-based and does not allow for partial units.
Billing Tips
- Ensure the claim is submitted using the terminal patient's health number, even if the counselling was provided exclusively to the family members or representatives.
Effective: April 1, 2025
AQ. Appendix Q
APPENDIX Q
Other
Psychotherapy, Psychiatric and Counselling Services
The claim must be submitted under the health number of the patient who is catastrophically or terminally ill.
Claims submission instruction: The claim must be submitted under the health number of the patient who is catastrophically or terminally ill.
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