W292 – Type 1 - Admission Assessment
OHIP Neurology Code — Infectious Disease (46) · Schedule of Benefits
A Type 1 admission assessment is a general assessment rendered to a patient on admission to a non-emergency long-term care institution. 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, excluding patients in designated palliative care beds. As per the definition of a general assessment in , this service requires a full history (including history of the presenting complaint, family medical history, past medical history, social history, and a functional inquiry into all body parts and systems) and an examination of all body parts and systems, unless not medically indicated or refused.
When to Use
- Use W292 when performing the initial comprehensive admission assessment for a patient entering a long-term care facility or chronic care hospital bed.
- Use this code for the initial intake assessment in a convalescent hospital setting, provided the patient is not in a designated palliative care bed.
Common Pitfalls
- Billing W292 in the same month as W010 will result in an automatic rejection, as the admission assessment is considered bundled into the monthly management fee.
- Claiming W292 when a consultation or general assessment was already billed for the same patient immediately prior to admission will trigger a mandatory fee reduction.
Billing Tips
- Ensure the clinical note explicitly documents a full systems review and comprehensive history to satisfy the GP21 general assessment requirements, as this is the primary target for post-payment audits.
Effective: June 1, 2025
Consultations and Visits
Infectious Disease (46)
General Assessment
Hospital and Institutional Consultations and Assessments, Assessments
A full history (including history of the presenting complaint, family medical history, past medical history, social history, and a functional inquiry into all body parts and systems) and an examination of all body parts and systems, unless not medically indicated or refused.
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