W294 – Subsequent visit - Infectious Disease
OHIP Neurology Code — CONSULTATIONS AND VISITS · 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 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 specific elements of assessments outlined in the Schedule of Benefits on page .
When to Use
- Use W294 when performing the initial assessment for a patient being admitted to a nursing home or home for the aged, provided you have already completed a consultation or general assessment for that patient prior to the admission.
- Apply this code for the first post-admission assessment in a chronic care or convalescent hospital bed when the patient has a pre-existing clinical relationship established through a prior assessment.
Common Pitfalls
- Billing W294 in the same month as the monthly management fee W010 will result in a rejection, as the assessment is considered inclusive of the management fee.
- Attempting to claim special visit premiums (e.g., K962, K963) with W294 is prohibited; these premiums are only applicable to 'A' prefix codes for in-patient emergency visits.
Billing Tips
- Ensure your records clearly link the prior consultation or general assessment to the current admission to satisfy the requirement that the service follows a previously rendered assessment for the same condition.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Assessment
Hospital and Institutional Consultations and Assessments
This service is for 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.
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