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Q642

Q642Q642

OHIP Critical Care Code · Schedule of Benefits

When to Use

  • Use Q642 as a tracking code to indicate that a patient has been enrolled in the Chronic Disease Management (CDM) program for diabetes.
  • Apply this code when submitting the initial enrollment for a patient who meets the clinical criteria for the diabetes management incentive.

Common Pitfalls

  • Billing Q642 without having a valid, signed enrollment form on file, which is a primary trigger for Ministry of Health audits.
  • Attempting to bill Q642 for a patient already enrolled by another physician, which will result in a rejection due to duplicate enrollment.

Billing Tips

  • Ensure Q642 is submitted on the same claim as the initial assessment or management visit to confirm the start date of the incentive period.
Provider Fee$0.00

Effective: October 1, 2008

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