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W152
W152 – First 4 Subsequent Visits per Patient per Month per Visit
OHIP Neurology Code — Endocrinology & Metabolism (15) · Schedule of Benefits
A subsequent visit is any routine assessment following the patient's admission to a long-term care institution, as defined on . W152 is for the first four subsequent visits per patient, per month, rendered by a specialist in Endocrinology & Metabolism in a chronic care or convalescent hospital. Additional subsequent visits (up to a maximum of 6 total per patient per month) are claimed using W151.
When to Use
- Use W152 for the first four routine follow-up assessments of an established patient in a chronic or convalescent care facility within a single calendar month.
- Select W152 when managing stable endocrine conditions in a long-term care setting where the patient has already been admitted and the initial consultation is complete.
Common Pitfalls
- Claiming W152 for visits beyond the fourth occurrence in a month will result in rejection; use W151 for the fifth and sixth visits.
- Billing W152 for patients in designated palliative care beds is incorrect, as these patients fall under different institutional billing categories.
- Attempting to bill W152 in conjunction with an emergency visit code will trigger an audit, as W152 is strictly for routine subsequent care.
Billing Tips
- Track your monthly visit count per patient carefully to ensure you switch from W152 to W151 immediately upon the fifth visit to avoid manual reconciliation.
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