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W071
W071 – Additional subsequent visits - chronic care or convalescent hospital
OHIP Neurology Code — CONSULTATIONS AND VISITS · Schedule of Benefits
This service is for a routine assessment following the patient's admission to a chronic care or convalescent hospital, as described in . It is specifically for additional subsequent visits, payable only after the first four subsequent visits for the same patient in the same month have been claimed using W072. As a subsequent visit, it includes all the specific elements of assessments defined in , such as a direct physical encounter, history, examination, and providing advice to the patient.
When to Use
- Use W071 for the fifth through tenth subsequent visits in a single calendar month for a patient in a chronic care or convalescent facility, provided four W072 claims have already been processed.
- Use this code when the patient requires ongoing monitoring beyond the initial four visits covered by W072, ensuring the documentation reflects a distinct physical encounter.
Common Pitfalls
- Billing W071 before the fourth W072 claim for the same patient in the same month will result in an automatic rejection.
- Attempting to claim W071 in conjunction with special visit premiums (e.g., travel or after-hours) is prohibited; you must use an 'A' prefix code instead if the criteria for a special visit are met.
- Exceeding the monthly limit of six W071 claims per patient will trigger a rejection, as the total allowed subsequent visits for this category is capped.
Billing Tips
- Track your monthly count of W072 claims carefully, as W071 is strictly a 'top-up' code that requires the threshold of four W072 claims to be met first.
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