W297 – Admission Assessment - Type 3
OHIP Neurology Code — Infectious Disease (46) · Schedule of Benefits
A Type 3 admission assessment is a general re-assessment of a patient who is re-admitted to a long-term care institution after a minimum 3 day stay in another institution. As a general re-assessment, it includes all the services listed for a general assessment, with the exception of the patient's history, which need not include all the details already obtained in the original assessment (see ). This service applies to patients in: - Chronic Care Hospitals - Convalescent Hospitals - Nursing Homes - Homes for the Aged - Designated chronic or convalescent care beds in hospitals This service is not applicable to patients in designated palliative care beds. For emergency calls and other special visits to in-patients, use General Listings ('A' prefix codes) and Premiums.
When to Use
- Use W297 when a patient returns to their long-term care facility following an acute care hospital admission lasting at least 3 days.
- Apply this code for a comprehensive re-assessment when the patient's clinical status has changed significantly during their absence, necessitating a new care plan.
Common Pitfalls
- Billing W297 in the same month as W010 will trigger a rejection, as the monthly management fee is intended to cover routine institutional care.
- Submitting W297 more than twice in a 12-month period will result in an automatic payment reduction to a lower assessment fee level.
- Using W297 for patients in palliative care beds is prohibited; these patients require different assessment codes.
Billing Tips
- Ensure the patient's chart clearly documents the duration of the hospital stay (minimum 3 days) to justify the use of W297 over a standard visit code.
Effective: June 1, 2025
Consultations and Visits
Infectious Disease (46)
Assessment
Hospital and Institutional Consultations and Assessments
A Type 3 admission assessment is a general re-assessment of a patient who is re-admitted to the long-term care institution after a minimum 3 day stay in another institution.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.