W150 – Comprehensive Endocrinology Consultation
OHIP Neurology Code — Endocrinology & Metabolism (15) · Schedule of Benefits
A comprehensive endocrinology consultation provided by a specialist in Endocrinology & Metabolism for a patient in a non-emergency, long-term care setting. This service is explicitly subject to the same conditions as A150. As a 'W' prefix service, it is intended for patients in Chronic Care Hospitals, Convalescent Hospitals, Nursing Homes, Homes for the Aged, or designated chronic or convalescent care beds in hospitals. It is not payable for patients in designated palliative care beds. For emergency calls to these locations, A prefix codes and special visit premiums apply (see to ). As a consultation, this service must follow a written request from a referring physician, nurse practitioner, or dental surgeon, and the consultant must provide a written report back to the referring provider as detailed in . The service includes all the specific elements of an assessment as per , such as a direct physical encounter, history taking, performing necessary procedures not separately billable, arranging related assessments or therapy, arranging follow-up, and discussion with the patient or their representative.
When to Use
- Use W150 for the initial comprehensive evaluation of a patient residing in a long-term care facility or chronic care hospital when requested by the primary provider for an endocrinological issue.
- Use W150 instead of W152 when the clinical complexity requires a full consultation report and formal referral, rather than a limited assessment.
Common Pitfalls
- Billing W150 for patients in palliative care beds is a common audit trigger; ensure the patient's bed designation is chronic or convalescent care.
- Failing to document the formal written referral request from the primary provider will lead to a clawback, as W150 strictly follows A150 consultation requirements.
- Billing W150 for an emergency consult in a long-term care setting is incorrect; emergency services in these facilities require A-prefix codes combined with applicable special visit premiums.
Billing Tips
- Ensure the consultation report is sent specifically to the referring provider, as the Ministry requires proof of this communication to validate the consultation fee.
- If the patient is under 16 years of age, remember to append the appropriate age-based premium to the W150 fee to maximize the claim value.
Effective: June 1, 2025
Consultations and Visits
Endocrinology & Metabolism (15)
Consultation
Hospital and Institutional Consultations and Assessments, Consultations
A copy of the written request for the consultation, signed by the referring physician, nurse practitioner or dental surgeon must be kept in the consulting physician's medical record, except in the case of a consultation which occurs in a hospital, long-term care institution or multi-specialty clinic where common medical records are maintained. In such cases, the written request may be contained on the common medical record.
The request identifies the consultant by name, the referring physician, nurse practitioner or dental surgeon by name and billing number, and identifies the patient by name and health number.
The written request sets out the information relevant to the referral and specifies the service(s) required.
A written report (including findings, opinions, and recommendations) must be prepared and sent to the referring physician, nurse practitioner or dental surgeon.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.