All codes
Q090
Q090 – Q090
OHIP Critical Care Code · Schedule of Benefits
When to Use
- Use Q090 as the mandatory administrative code when submitting a claim for the Chronic Disease Management (CDM) incentive for patients with diabetes, hypertension, CHF, or COPD.
- Apply this code alongside the appropriate fee-for-service visit code (e.g., A007) to trigger the payment of the associated Q040, Q041, Q042, or Q043 incentive premiums.
Common Pitfalls
- Submitting Q090 without an associated qualifying visit code will result in a rejection, as it is a tracking code rather than a standalone service code.
- Billing Q090 for a patient who does not meet the specific diagnostic criteria defined for the CDM program will trigger an audit flag for inappropriate incentive claiming.
Billing Tips
- Ensure the diagnostic code linked to the visit matches the chronic condition required for the specific Q-code incentive you are claiming to avoid automated claim rejection.
Provider Fee$0.00
Effective: March 1, 2007
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