W102 – Type 1 admission assessment
OHIP Neurology Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A Type 1 admission assessment is defined as a general assessment rendered to a patient on admission to a long-term care facility, such as a chronic care hospital, convalescent hospital, nursing home, or home for the aged. It includes all the specific elements of a general assessment as described in the Schedule, including a full history and comprehensive physical examination. If the physician has previously rendered a consultation, general assessment, or general re-assessment of the patient prior to admission, the amount payable for this service will be adjusted to a lesser fee. This service is also a component of the W010 Monthly Management fee.
When to Use
- Use W102 when performing the initial comprehensive admission assessment for a patient newly admitted to a long-term care facility, nursing home, or chronic care hospital.
- Use this code when the patient has not received a consultation or general assessment from you within the immediate period prior to admission to avoid the automatic fee reduction.
Common Pitfalls
- Billing W102 in the same month as W010 will result in a rejection, as W102 is considered a component of the monthly management fee.
- Failing to account for the automatic fee reduction when you have previously billed an A003 or similar assessment for the same patient shortly before their admission.
Billing Tips
- Always append the age premium (15%) if the patient is 65 years or older to maximize the claim value for this assessment.
- Ensure your documentation explicitly mirrors the requirements of a general assessment, as W102 is subject to strict audit scrutiny regarding the completeness of the physical exam and history.
Effective: April 1, 2026
A. Consultations and Visits
CONSULTATIONS AND VISITS
Assessment
Hospital and Institutional Consultations and Assessments, Assessments
A general assessment requires documentation of a full history (the elements of which must include a history of the presenting complaint, family medical history, past medical history, social history, and a functional inquiry into all body parts and systems) and, except for breast, genital or rectal examination where not medically indicated or refused, an examination of all body parts and systems.
These services apply to patients in chronic care hospitals, convalescent hospitals, nursing homes, homes for the aged and designated chronic or convalescent care beds in hospitals other than patients in designated palliative care beds - “W” prefix services.
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