All codes
Q613
Q613 – Q613
OHIP Critical Care Code · Schedule of Benefits
When to Use
- Use Q613 to bill for the completion of a specialized form or report that is not covered by a standard visit fee, specifically when requested by a third party.
- Apply this code when submitting a report for a patient's disability or insurance claim where the physician is entitled to a fee for service but the specific form does not have a unique OHIP code.
Common Pitfalls
- Billing Q613 in conjunction with a standard office visit (A007) for the same patient on the same day is often flagged for audit if the documentation does not clearly separate the clinical assessment from the administrative report time.
- Submitting Q613 for reports that are considered part of the 'insured services' definition, such as standard sick notes or basic referrals, will result in automatic rejection.
Billing Tips
- Ensure the third-party request is clearly documented in the chart, including the date of the request and the specific entity requiring the report, to defend against potential Ministry of Health inquiries.
Provider Fee$0.00
Effective: October 1, 2008
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