W180 – Special neurology consultation
OHIP Neurology Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A special neurology consultation rendered by a neurologist for a non-emergency in-patient in a long-term care institution (Chronic Care Hospital, Convalescent Hospital, Nursing Home, Home for the Aged, or designated chronic/convalescent care beds). This service is provided following a written request from a referring practitioner due to the complexity, seriousness, or obscurity of the case. It includes a comprehensive assessment and a written report to the referring practitioner. The physician must spend a minimum of 75 minutes in direct contact with the patient, exclusive of time spent rendering any other separately billable intervention. The start and stop times of the service must be recorded in the patient's permanent medical record. This service is subject to the same conditions as A180. For emergency calls and other special visits to these in-patients, use General Listings ('A' prefix codes) and applicable special visit premiums.
When to Use
- Use W180 for a complex, non-emergency neurology consultation in a long-term care facility when the 75-minute direct patient contact threshold is met.
- Choose W180 over A180 when the patient is specifically located in a chronic care, convalescent, or nursing home setting to ensure the correct institutional premium eligibility.
Common Pitfalls
- Billing W180 without explicit start and stop times recorded in the chart is a primary cause for audit recovery, as the 75-minute minimum is a strict requirement.
- Failing to secure a written referral request from the attending practitioner prior to the service will result in the claim being downgraded to a lesser assessment fee.
- Attempting to bill W180 for emergency situations where a special visit premium would be more appropriate; W180 is strictly for non-emergency, planned consultations.
Billing Tips
- Ensure your documentation clearly distinguishes the 75 minutes of direct patient contact from any administrative time or report writing, as the latter cannot be included in the time calculation.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Consultation
Consultations, Hospital and Institutional Consultations and Assessments
A copy of the written request for the consultation, signed by the referring practitioner, must be kept in the consulting physician's medical record (or on the common medical record in a shared facility).
The 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 the information relevant to the referral and specify the service(s) required.
The consultant must prepare a written report (including findings, opinions, and recommendations) to the referring practitioner.
The start and stop times of the service must be recorded in the patient's permanent medical record.
Subject to the same conditions as A180.
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