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W073
W073 – First 2 subsequent visits per patient per month - Nursing home or home for the aged
OHIP Neurology Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A routine assessment rendered by a Geriatrician (specialty 07) following a patient's admission to a nursing home or home for the aged, as described in . This service is limited to the first 2 subsequent visits per patient per month. A subsequent visit includes all the common (-) and specific elements of an assessment (), such as a direct physical encounter, history, examination, and providing advice. For emergency calls or other special visits, General Listings ('A' prefix codes) and Special Visit Premiums should be used instead (see to ).
When to Use
- Use W073 for the first two routine follow-up assessments per month for a patient in a long-term care facility when you are not the primary provider claiming the W010 monthly management fee.
- Use this code for scheduled geriatric assessments that occur after the initial admission visit (W071) but before reaching the monthly limit of two visits.
Common Pitfalls
- Billing W073 when the W010 monthly management fee has already been claimed for the patient by any physician, as W073 is considered included in the W010 payment.
- Submitting more than two W073 claims per patient per month, which will trigger automatic rejections; use W078 for the third visit instead.
- Attempting to claim W073 alongside emergency 'A' prefix codes or special visit premiums, which are mutually exclusive for this service.
Billing Tips
- Ensure your billing software tracks the monthly count of W073 and W078 visits to prevent exceeding the combined limit of five subsequent visits per month.
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