All codes
Q526
Q526 – Q526
OHIP Critical Care Code · Schedule of Benefits
When to Use
- Use Q526 to bill for the administration of an influenza vaccine when the vaccine product is provided by the Ministry of Health.
- Apply this code when the primary purpose of the patient visit is solely for the administration of the influenza vaccine.
- Use this code for patients aged 6 months and older who receive the publicly funded influenza immunization.
Common Pitfalls
- Billing Q526 in conjunction with a full assessment code like A007 is generally rejected unless the patient has a separate, unrelated acute medical issue addressed during the same visit.
- Attempting to bill Q526 for non-influenza vaccines, which require different administrative codes or are covered under the global fee for specific programs.
- Submitting Q526 without the appropriate diagnostic code (usually V04) will result in an automatic rejection.
Billing Tips
- If a patient presents for an influenza shot and a separate, medically necessary assessment for a different condition, bill the assessment code with the appropriate diagnostic code and append the 'IE' modifier to the assessment to avoid rejection.
Provider Fee$0.00
Effective: November 1, 2007
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