W176 – Not found
OHIP Neurology Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A repeat consultation is an additional consultation rendered by the same consultant for the same presenting problem, after the patient has received care from another physician since the initial consultation. This service requires a new written request from the referring practitioner and adheres to all the requirements of a standard consultation. It is intended for non-emergency situations in long-term care institutions as defined in the Schedule of Benefits (e.g., chronic care hospitals, convalescent hospitals, nursing homes, homes for the aged). For emergency calls or special visits, 'A' prefix General Listings codes should be used instead.
When to Use
- Use W176 when providing a formal repeat consultation for a chronic condition in a long-term care facility after the patient has been managed by another physician since your initial consultation.
- Use W176 for non-urgent, scheduled reassessments in nursing homes or chronic care hospitals where a new written referral request has been generated by the attending practitioner.
Common Pitfalls
- Billing W176 for emergency or acute care visits in a hospital setting, which must be billed using 'A' prefix General Listings codes instead.
- Failing to obtain or document a new, specific written request for the repeat consultation, which will result in a downgrade to a lower-value assessment code upon audit.
- Confusing W176 with a standard follow-up visit; W176 requires the formal referral process and documentation standards of an initial consultation.
Billing Tips
- Ensure the referring practitioner's name and billing number are clearly linked to the specific W176 claim to satisfy the written request requirement.
- Apply the appropriate age-based premium (e.g., for pediatric patients in long-term care) to the W176 base fee to maximize the claim value.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Consultation
Hospital and Institutional Consultations and Assessments, Consultations
A repeat consultation has the same requirements as a consultation including the requirement for a new written request by the referring physician, nurse practitioner or dental surgeon.
A copy of the written request for the consultation, signed by the referring practitioner, must be kept in the consulting physician's medical record (unless a common medical record is maintained).
The written request must identify the consultant by name, the referring practitioner by name and billing number, and the patient by name and health number.
The written request must set out information relevant to the referral and specify the service(s) required.
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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