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W133
W133 – Subsequent Visit - Nursing Home or Home for the Aged
OHIP Neurology Code — Internal and Occupational Medicine (13) · Schedule of Benefits
Represents one of the first two subsequent visits per patient per month in a nursing home or home for the aged. A subsequent visit is any routine assessment following the patient's admission to a long-term care institution (see ). This service, rendered by a specialist in Internal Medicine or Occupational Medicine, is limited to the first two subsequent visits per patient, per month. For additional visits, see W138. It is not payable in the same month as the monthly management fee (W010).
When to Use
- Use W133 for the first or second routine follow-up assessment of a patient in a long-term care facility within a calendar month.
- Use W133 when providing non-urgent, scheduled clinical reviews that do not qualify for the monthly management fee W010.
Common Pitfalls
- Claiming W133 in the same month as W010 will trigger an automatic rejection, as the monthly management fee is intended to cover routine care.
- Attempting to attach special visit premiums to W133 is invalid; use an 'A' prefix code instead if the visit meets the criteria for a special visit premium.
- Exceeding the two-visit limit per month with W133 will result in payment rejection; subsequent visits beyond the first two must be billed as W138.
Billing Tips
- Track your monthly visit count per patient carefully to ensure you switch from W133 to W138 for the third and any subsequent visits within the same calendar month.
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