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Q123A
Q123A – Cumulative Preventive Care Management Service Enhancement Code (Preventive Care Bonus) Colorectal Cancer Screening
OHIP Critical Care Code — APPENDIX Q · Schedule of Benefits
This is an enhancement code for a cumulative preventive care bonus related to colorectal cancer screening. The bonus is described as '70% ($4000)' and is payable to physicians in specific patient enrolment models: RNPGA, BSM, GHC, SJHC, SEAMO, WHA, CCM, and FHG. Eligibility requires the physician to meet a minimum roster size. The service is billed at $0.00, indicating it is a tracking code for a bonus payment calculated and paid by the Ministry.
When to Use
- Use Q123A to track and trigger the colorectal cancer screening bonus payment for eligible patients within your roster who have completed the required screening.
- Apply this code when you have met the specific roster size requirements defined for your enrolment model (e.g., FHG, CCM) to ensure the Ministry calculates your performance-based bonus.
Common Pitfalls
- Billing Q123A for patients who do not meet the age-appropriate screening criteria or who have not completed the required FIT or colonoscopy, leading to audit discrepancies.
- Failing to ensure the patient is correctly attached to your roster, as Q123A will not trigger a payment if the patient is not formally enrolled in your specific model.
Billing Tips
- Ensure your EMR is configured to automatically flag patients due for colorectal screening so that Q123A is captured immediately upon the completion of the screening service.
- Verify your current roster size against the minimum thresholds for your specific model (e.g., FHG or BSM) before expecting the Q123A bonus payment to be processed.
Provider Fee$0.00
Effective: March 31, 2009
Category
AQ. Appendix Q
Subcategory
APPENDIX Q
Service Type
Other
Code Classes
Other Premiums (including After Hours Procedure Premiums)
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