All codes
Q040
Q040 – Diabetes management incentive
OHIP Consultations and Visits Code — CONSULTATIONS AND VISITS · Schedule of Benefits
Diabetes management incentive (DMI) is a service rendered by the General/Family Physician most responsible for providing ongoing management of a diabetic patient. The service consists of ongoing management using a planned care approach consistent with the required elements of the Canadian Diabetes Association (CDA) Clinical Practice Guidelines, documenting that all of the CDA required elements have been provided for the previous 12 month period and must include documentation that tracks, at a minimum, the following:
• Lipids, cholesterol, HbA1C, blood pressure, weight and body mass index (BMI), and medication dosage;
• Discussion and offer of preventive measures including vascular protection, influenza and pneumococcal vaccination;
• Health promotion counselling and patient self-management support;
• Albumin to creatinine ratio (ACR);
• Discussion and offer of referral for dilated eye examination; and
• Foot examination and neurologic examination.
A flow sheet or other documentation that records all of the required elements of the most current CDA guidelines must be included in the patient's permanent medical record, or the service is not eligible for payment.
The flow sheet must track, at a minimum, the following:
• Lipids, cholesterol, HbA1C, blood pressure, weight and body mass index (BMI), and medication dosage
• Discussion and offer of preventive measures including vascular protection, influenza and pneumococcal vaccination
• Health promotion counselling and patient self-management support
• Albumin to creatinine ratio (ACR)
• Discussion and offer of referral for dilated eye examination
• Foot examination and neurologic examination
Claims for Q040 must be submitted only when the required elements of the service have been completed for the previous 12 month period.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.