W234 – Admission assessment - Type 2
OHIP Neurology Code — INTERNAL AND OCCUPATIONAL MEDICINE (13) · Schedule of Benefits
A Type 2 admission assessment occurs when the admitting physician makes an initial visit to assess the condition of the patient following admission to a long-term care institution and has previously rendered a consultation, general assessment or general re-assessment of the patient prior to admission. This service applies to patients in chronic care hospitals, convalescent hospitals, nursing homes, homes for the aged, and designated chronic or convalescent care beds in hospitals, other than patients in designated palliative care beds. As an assessment, this service includes the required specific elements outlined in the Schedule of Benefits (see ).
When to Use
- Use W234 when you have performed a consultation or general assessment on the patient within the community and are now performing the formal admission assessment following their transfer to a long-term care facility.
- Use W234 specifically for patients entering chronic care, convalescent hospitals, or nursing homes where you have an established clinical relationship prior to the admission event.
Common Pitfalls
- Billing W234 in the same calendar month as W010 will trigger an automatic rejection, as the admission assessment is considered bundled into the monthly management fee.
- Attempting to bill W234 for patients in designated palliative care beds is incorrect, as these patients fall under different institutional billing frameworks.
Billing Tips
- Ensure your documentation explicitly references the prior consultation or assessment date to justify the use of the Type 2 code (W234) over the higher-valued Type 1 admission assessment (W232).
Effective: June 1, 2025
A. Consultations and Visits
INTERNAL AND OCCUPATIONAL MEDICINE (13)
Assessment
Hospital and Institutional Consultations and Assessments
As an assessment, the service requires a direct physical encounter with the patient, including taking a patient history and performing a physical examination as appropriate to the service.
All standard medical record-keeping requirements apply as per and .
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