All codes
Q617
Q617 – Q617
OHIP Critical Care Code · Schedule of Benefits
When to Use
- Use Q617 to claim the 'Chronic Disease Management Incentive' for patients with diabetes, hypertension, congestive heart failure, or COPD who have had at least two visits for the condition in the previous 12 months.
- Apply this code when you have completed a comprehensive review of the patient's chronic condition management plan, provided the patient is enrolled in your FHO or FHN.
Common Pitfalls
- Billing Q617 more than once per patient per 12-month period will result in an automatic rejection.
- Attempting to bill Q617 on the same day as a comprehensive assessment (A007 or A008) is prohibited and will cause a billing conflict.
- Failure to meet the minimum threshold of two previous visits for the specific chronic condition within the preceding year will trigger a claim audit.
Billing Tips
- Ensure the patient's diagnosis code for the chronic condition is clearly linked to the claim to satisfy the Ministry's validation requirements for the incentive payment.
Provider Fee$0.00
Effective: October 1, 2008
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