All codes
Q635
Q635 – Q635
OHIP Critical Care Code · Schedule of Benefits
When to Use
- Use Q635 as the mandatory tracking code when billing the K035A chronic disease management incentive for patients with diabetes.
- Apply Q635 to the claim when you have completed the annual comprehensive review and management plan for a diabetic patient to satisfy the K035A billing requirements.
Common Pitfalls
- Billing Q635 without an associated K035A claim will result in a rejection, as Q635 is a non-fee tracking code that must be linked to the incentive.
- Submitting Q635 for patients who do not have a confirmed diagnosis of diabetes in the patient registry or medical record will trigger an audit flag for inappropriate incentive claims.
Billing Tips
- Ensure Q635 is submitted on the same claim as K035A to confirm the service was provided within the required annual timeframe.
Provider Fee$0.00
Effective: October 1, 2008
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