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W232

W232Admission assessment - Type 1

OHIP Neurology Code — INTERNAL AND OCCUPATIONAL MEDICINE (13) · Schedule of Benefits

A Type 1 admission assessment applicable to specialists in Internal and Occupational Medicine (13) for patients in a non-emergency long-term care setting. A Type 1 admission assessment is defined as a general assessment rendered to a patient on admission (). The requirements of a general assessment include a full history and a comprehensive physical examination of all body systems as detailed on . This service is applicable to patients in: - chronic care hospitals - convalescent hospitals - nursing homes - homes for the aged - designated chronic or convalescent care beds in hospitals This service excludes patients in designated palliative care beds. For emergency calls and other special visits to these in-patients, physicians should use the General Listings ('A' prefix codes) and applicable Special Visit Premiums.

When to Use

  • Use W232 for the initial comprehensive admission assessment of a patient newly admitted to a nursing home or chronic care facility.
  • Use this code when performing a full systems review and physical examination as defined by GP21 requirements for patients in non-emergency long-term care beds.

Common Pitfalls

  • Billing W232 for patients in designated palliative care beds, which are explicitly excluded from this code's coverage.
  • Failing to document a full systems review or physical examination, which risks clawbacks as W232 requires the same rigor as a general assessment (GP21).
  • Attempting to bill W232 for emergency visits; these must be billed using 'A' prefix codes and applicable Special Visit Premiums instead.

Billing Tips

  • Ensure the patient's admission status is correctly identified as non-emergency long-term care to avoid rejection against the facility type.
  • Always append the appropriate W-series Special Visit Premium (e.g., W990) if the visit occurs outside of standard hours or requires travel to the facility.
Provider Fee$0.00
Specialist Fee$69.35

Effective: June 1, 2025

Category

A. Consultations and Visits

Subcategory

INTERNAL AND OCCUPATIONAL MEDICINE (13)

Service Type

Assessment

Code Classes

Hospital and Institutional Consultations and Assessments, Assessments

As this is a Type 1 Admission Assessment, it is defined as a general assessment. The requirements for a general assessment, outlined on , must be met in the patient's medical record. This includes:

- A full history (presenting complaint, family medical history, past medical history, social history, and functional inquiry into all body parts and systems).

- An examination of all body parts and systems (except for breast, genital or rectal examination where not medically indicated or refused).

This code is listed under NON-EMERGENCY LONG-TERM CARE IN-PATIENT SERVICES. For emergency calls and other special visits to in-patients, use General Listings and Premiums when applicable - see to .

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