W052 – Subsequent visits - chronic care or convalescent hospital - first 4 per patient per month
OHIP Neurology Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A subsequent visit for a patient in a chronic care or convalescent hospital, rendered by a physician with a Community Medicine (05) specialty. This code is for the first four subsequent visits per patient per month. A subsequent visit is any routine assessment following a patient's admission to a long-term care institution (see General Preamble ).
When to Use
- Use W052 for routine, scheduled follow-up assessments of chronic care patients within the first four visits of the calendar month.
- Apply this code when managing stable, ongoing care for patients admitted to a convalescent hospital setting.
Common Pitfalls
- Billing W052 for an acute intercurrent illness; these must be billed using W121 to ensure appropriate compensation for the increased complexity.
- Attempting to attach special visit premiums to W052; these are strictly prohibited for W-prefix codes per GP69.
- Billing W052 for an emergency assessment of another physician's patient; this requires an A-prefix code from the General Listings.
Billing Tips
- Monitor your monthly visit count per patient closely, as W052 is strictly limited to the first four visits, after which you must transition to the appropriate subsequent visit code.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Assessment
Hospital and Institutional Consultations and Assessments
This code is for use in a chronic care or convalescent hospital.
See General Preamble for general rules regarding subsequent visits in Long-Term Care Institutions.
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