W151 – Additional Subsequent Visit in Chronic Care or Convalescent Hospital
OHIP Neurology Code — Endocrinology & Metabolism (15) · Schedule of Benefits
Represents an additional subsequent visit by a physician with a specialty in Endocrinology & Metabolism (15) to a patient in a chronic care or convalescent hospital. This service is intended for use after the first 4 subsequent visits in a month have been claimed using W152. A maximum of 6 W151 visits can be claimed per patient per month. This service falls under Non-Emergency Long-Term Care In-Patient Services. For general rules on subsequent visits in long-term care institutions, refer to .
When to Use
- Use W151 only after you have already billed the maximum of 4 visits using W152 within the same calendar month for a chronic care or convalescent patient.
- Apply this code for routine follow-up assessments when the patient's condition is stable and does not meet the criteria for an acute intercurrent illness visit under W121.
Common Pitfalls
- Billing W151 in the same month as W010 will result in an automatic rejection, as W151 is considered included in the monthly management fee.
- Exceeding the hard limit of 6 claims for W151 per patient per month will trigger a rejection from the Ministry.
- Failing to track the sequence of W152 claims first; W151 is only valid as the 5th through 10th subsequent visit in a month.
Billing Tips
- If the patient develops an acute intercurrent illness, bill W121 instead of W151, as W121 is not subject to the monthly visit caps and remains payable regardless of the W152/W151 count.
Effective: June 1, 2025
Consultations and Visits
Endocrinology & Metabolism (15)
Assessment
Hospital and Institutional Consultations and Assessments
See General Preamble for rules regarding subsequent visits in Long-Term Care Institutions.
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