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W221
W221 – Genetics - additional subsequent visits - chronic care or convalescent hospital
OHIP Neurology Code — CONSULTATIONS AND VISITS · Schedule of Benefits
This service represents an additional routine assessment following a patient's admission to a chronic care or convalescent hospital, rendered by a physician with a specialty in Genetics (22). This fee code applies to the 5th and 6th subsequent visits per patient, per month. It is subject to the general rules for subsequent visits in long-term care institutions as described in the General Preamble (see ).
When to Use
- Use W221 specifically for the 5th and 6th subsequent visits in a calendar month for a patient admitted to a chronic care or convalescent facility.
- Apply this code when you have already exhausted the initial subsequent visit codes for the month and require additional routine assessment billing for a genetics-related chronic condition.
Common Pitfalls
- Billing W221 in the same month as W010 will result in an automatic rejection, as the monthly management fee covers all routine subsequent visits.
- Exceeding the 6-visit monthly limit for subsequent visits in chronic care will lead to claim denials, as W221 is strictly limited to the 5th and 6th visits.
Billing Tips
- Ensure your billing software or manual entry tracks the cumulative count of subsequent visits per patient per month to avoid claiming W221 before the 5th visit threshold is met.
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