W063 – Nursing home or home for the aged - first 2 subsequent visits per patient 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, as defined in . This specific service, W063, is payable for the first two subsequent visits per patient per month by an orthopaedic surgeon for a patient in a nursing home or home for the aged.
When to Use
- Use W063 for routine follow-up assessments of an orthopaedic condition in a nursing home when you are not the Most Responsible Physician (MRP) claiming W010.
- Use W063 for the first or second routine visit of the month when the patient does not require management for an acute intercurrent illness.
Common Pitfalls
- Claiming W063 when you are the MRP who has already billed W010 for the same patient in the same month, as W063 is considered a component of the monthly management fee.
- Attempting to attach special visit premiums to W063, which is prohibited as these are considered routine institutional rounds.
- Billing W063 for acute intercurrent illness visits, which should instead be billed under W121 to ensure they are not subject to the monthly visit limits.
Billing Tips
- If you are managing an acute intercurrent illness, prioritize billing W121 instead of W063 to bypass the monthly visit count restrictions and ensure payment for the acute service.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Assessment
Hospital and Institutional Consultations and Assessments
See General Preamble for general rules on subsequent visits in long-term care institutions.
For emergency calls and other special visits to in-patients, use General Listings and Premiums when applicable (see General Preamble to ).
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