The Basics
Review message that may occur when processing a claim for root canal therapy
What is an H02?
Proper releasing order when you receive a claim/estimate
What is release the claim(s) and then the estimate?
Remark code to be used when a claim is submitted with a lab charge
What is M54?
Path where you can locate fee guides
What is resources then resources?
QC SP 12400 to QC GP
What is 12400?
The highest number of units you can have for one scaling code
What is 6? (11116)
Maximum amount allowed towards an initial payment
What is 40 percent of the total submitted?
Review message that may appear when anaesthethia is submitted on its own.
What is H06?
Link for locating assignment of benefits routines
What is guidelines then guidelines then click the assignment of benefits link?
DH 00215 to CDA
What is 02145?
Name for when the mouth is divided into 6 sections.
What is a sextant?
Remark code to be used when you receive a monthly fee without a treatment plan on file
What is DU3?
Process to be followed when procedure codes submitted with anaesthesia are not covered.
What is decline the anaesthesia as well?
Link for locating the policy search tool
What is Resources then click on Policy Search tool link on the right hand side of the page?
QC SP 74302 to QC GP
What is the is no GP equivalent code?
What the last digit in a restoration represents
What is the number of tooth surfaces being restored?
EOB remark to be entered when an ortho predetermination prompts remark code N05
What is nothing?
Two provinces where general anaesthetic is not found in the specialist fee guide.
What are Quebec and Nova Scotia?
Link for locating the M1S Route table
What is systems link then Ultera and then click on M1S Dental Route and Route for Review
DH 00524 to CDA
What is 43424?
The only 2 simple extraction procedure codes
What are 71101 and 71109?
Remark code to be used when a claimant submits a monthly fee that is $62.00 over the approved amount
What is A84?
Three procedure codes that fall under the lab processing routines
What are 99111, 99333, and 99555.
Path for locating the Quebec PR/PD routines
What is procedure link (diagnostic, endodontic, oral surgery, periodontic, preventative, restorative), choose one procedure code link and then click the Quebec PR/PD link on the right hand side of the page?
2 switches; QC SP 11420 to QC GP to CDA
What is 11420 to 11300 to 11101?