W124 – Subsequent visit – day of discharge (per visit)
OHIP Neurology Code · Schedule of Benefits
A subsequent visit rendered by the Most Responsible Physician (MRP) on the day of discharge from a long-term care institution (chronic care or convalescent hospital, nursing home, or home for the aged).
When to Use
- Use W124 when discharging a patient from a long-term care facility to home or a different facility after a minimum 30-day stay where you are the MRP.
- Use this code when you have completed the formal discharge summary, reconciled medications, and arranged for the patient's ongoing care transition.
Common Pitfalls
- Billing W124 for patients admitted for respite care, which is explicitly excluded from eligibility.
- Submitting W124 when the patient is being transferred within the same facility or to another unit under the same roof, as this does not meet the discharge criteria.
- Failing to meet the 30-day consecutive stay requirement, which triggers an automatic rejection or audit recovery.
Billing Tips
- Ensure your documentation explicitly confirms the 30-day stay duration and the transfer of care to a new provider to satisfy audit requirements for the W-prefix institutional claim.
Effective: April 1, 2026
Institutional
Assessment
Completion of the discharge summary by the physician within 48 hours of discharge.
Arranging for follow-up of the patient (as appropriate).
Prescription of discharge medications, if any.
The discharge summary must include as a minimum the following information: reason for admission, procedures performed during the hospitalization, discharge diagnosis, and medications on discharge.
In the case of conflicting claims, the physician to whom the patient has rostered (virtual or actual) may receive payment.
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