W171 – Additional Subsequent Visits (Maximum of 6 per Patient per Month) per Visit
OHIP Neurology Code — Vascular Surgery (17) · Schedule of Benefits
This service is an additional subsequent visit rendered by a Vascular Surgeon to a patient in a chronic care or convalescent hospital. It is intended for visits that occur after the first four subsequent visits in a calendar month, which are claimed using W172. The total number of routine subsequent visits, combining W172 and W171, is limited to six per patient per month. As a subsequent visit, it constitutes a routine assessment following the patient's admission (see ). Visits required for an acute intercurrent illness should be claimed using W121 and are not subject to this monthly limit (see ).
When to Use
- Use W171 for the 5th and 6th routine subsequent visits in a calendar month for a chronic care or convalescent patient after W172 has been billed four times.
- Use this code for routine monitoring of stable vascular conditions in a chronic care setting when no acute intercurrent illness is present.
Common Pitfalls
- Billing W171 before exhausting the four allowed W172 claims will result in automatic rejection or audit recovery.
- Attempting to bill W171 for an acute intercurrent illness instead of using W121, which is not subject to the six-visit monthly cap.
- Claiming W171 alongside the monthly management fee W010 when acting as the Most Responsible Physician in a long-term care facility.
Billing Tips
- Track your monthly visit count per patient carefully to ensure you transition from W172 to W171 only after the fourth visit to avoid payment errors.
Effective: June 1, 2025
Consultations and Visits
Vascular Surgery (17)
Assessment
Hospital and Institutional Consultations and Assessments
In addition to the <common_elements> (, ), all services described as assessments must include the <specific_elements> outlined in , such as a direct physical encounter, history taking, physical examination, and maintaining an appropriate medical record.
Subsequent visits (see General Preamble )
For emergency calls and other special visits to in-patients, use General Listings and Premiums when applicable - see General Preamble to .
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