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Q742

Q742Q742

OHIP Critical Care Code · Schedule of Benefits

When to Use

  • Use Q742 as the mandatory administrative code to bill the Chronic Disease Management (CDM) incentive for patients enrolled in your FHO or FHN roster.
  • Apply this code when submitting claims for the annual management of patients with specific chronic conditions like diabetes, hypertension, or COPD to trigger the associated fee-for-service premium.

Common Pitfalls

  • Billing Q742 for a patient who is not currently enrolled in your roster will result in an automatic rejection.
  • Attempting to bill Q742 in conjunction with a standard office visit code (A007) without meeting the specific diagnostic criteria for the chronic disease management program will lead to audit flags.

Billing Tips

  • Ensure Q742 is linked to the appropriate diagnostic code for the chronic condition being managed to satisfy the Ministry's validation requirements for the incentive payment.
Provider Fee$0.00

Effective: January 1, 2013

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