From time to time, we get questions about how to add attribute codes to the Canadian Classification of Health Interventions (CCI codes) on the Ontario Claim Forms (OCFs), when submitting claims to Health Claims for Auto Insurance (HCAI).
The attribute codes are used to specify how the service was delivered and the number of views for billed X-rays.
HCAI has provided Appendix B – Partial Pick List of Health Related Services & Intervention Codes (CCI) document on their website for reference. It states that: “healthcare services can be further specified with Attribute Codes.”
Here’s How You Apply the Codes
In many cases, when a patient is physically present for a visit, an attribute code is not required.
However, there are circumstances where using an attribute code is necessary, which we’ve outlined for you below.
These conclusions are based on analysis of Appendix B, specifically pages 4, 7 and 8.
Here are some guidelines to help you apply the attribute codes to the OCF form.
- If the service code starts with 1 and ends with 02
- then valid attribute codes are IN, SD, IM, GR and GS
- If the service code starts with 1 and ends with 06, 07, 09, or 12
- then the valid attribute code is IA
- If the service code starts with 6 and ends with 10, 07, 30, or 50
- then valid attribute codes are IN, SD, IM, GR, and GS
- If the service code starts with 7 and ends with 10, 59 or 60
- then valid attribute codes are IN, SD, IM, GR, and GS
The table below offers another way to look at the summary above.
Code Start | Code End | Attribute Code |
---|---|---|
1 | 02 | IN, SD, IM, GR, GS |
1 | 06, 07, 09, 12 | IA |
6 | 10, 07, 30, 50 | IN, SD, IM, GR, GS |
7 | 10, 59, 60 | IN, SD, IM, GR, GS |
We’ve also observed that if you ignore the above conditions and apply any attribute code to any CCI code, the system still successfully submits the OCF to HCAI. However, it’s always safer to stay within the rules. That way you avoid mistakes and unnecessary claim rejections.