W132 – Subsequent Visit in Chronic Care/convalescent Hospital
OHIP Neurology Code — Internal and Occupational Medicine (13) · Schedule of Benefits
Subsequent visit for a patient in a chronic care or convalescent hospital, rendered by a specialist in Internal Medicine (13). As defined in , a subsequent visit is any routine assessment following the patient's admission to a long-term care institution. The service includes the specific elements of an assessment (e.g., history, examination, advice) as described in and all common elements (, ). This code is for non-emergency, routine care. For emergency calls or other special visits, use General Listings ('A' prefix) and the appropriate special visit premiums.
When to Use
- Use W132 for routine, non-urgent follow-up assessments of patients admitted to chronic care or convalescent facilities.
- Apply this code when managing stable chronic conditions that do not meet the criteria for an acute intercurrent illness visit under W121.
- Select W132 for standard periodic reviews of a patient's care plan in a long-term care setting when the patient is under the care of an Internal Medicine specialist.
Common Pitfalls
- Billing W132 for patients receiving palliative care, which must be billed under W982 instead.
- Attempting to attach special visit premiums to W132, which will result in automatic rejection as these are considered routine, scheduled care.
- Exceeding the monthly frequency limits for subsequent visits, which triggers automatic payment adjustments or rejections by the Ministry.
Billing Tips
- If a patient develops an acute intercurrent illness requiring a more intensive assessment, switch to W121 to ensure appropriate compensation for the increased complexity.
- Ensure your documentation clearly distinguishes between routine maintenance visits (W132) and acute episodes (W121) to withstand potential post-payment audits.
Effective: June 1, 2025
Consultations and Visits
Internal and Occupational Medicine (13)
Assessment
Hospital and Institutional Consultations and Assessments
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