W023 – Dermatology subsequent visit - nursing home or home for the aged - first 2 per month
OHIP Neurology Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A subsequent visit is any routine assessment following the patient's admission to a long-term care institution, such as a nursing home or home for the aged. This service is for the first two subsequent visits provided by a Dermatologist to a patient within a calendar month. As per the general requirements for assessments (), this service includes a direct physical encounter with the patient, history taking, physical examination, arranging for related care, and providing advice to the patient or their representative. See for general rules on non-emergency in-patient services in long-term care institutions.
When to Use
- Use W023 for routine follow-up assessments of chronic dermatological conditions in a long-term care facility when you are not the Most Responsible Physician (MRP) claiming W010.
- Use this code for the first two monthly visits to monitor skin lesions or chronic inflammatory conditions where no acute intercurrent illness is present.
Common Pitfalls
- Claiming W023 when the MRP has already billed W010 for the same patient in the same month will result in a rejection, unless you are a specialist providing non-MRP care.
- Attempting to bill W023 for an acute flare-up or new infection; these must be billed as W121 or appropriate 'A' prefix codes with special visit premiums.
Billing Tips
- If you see the patient for a third or subsequent time in the same month, switch to W028 to ensure continued payment for routine care.
- Always verify if the patient's MRP has billed W010 to avoid automatic claim rejection for duplicate management services.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Assessment
Hospital and Institutional Consultations and Assessments
This code is for the first 2 subsequent visits per patient per month.
See and for general rules regarding subsequent visits in Long-Term Care Institutions and Palliative Care.
Subsequent visits (see General Preamble )
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