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W402
W402 – Admission assessment - Type 1
OHIP Consultations and Visits Code — CONSULTATIONS AND VISITS · 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 setting ().
Eligible Settings
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
• (Excludes patients in designated palliative care beds)
As a general assessment, this service requires a full history (presenting complaint, family medical history, past medical history, social history, and functional inquiry of all body systems) and a comprehensive physical examination of all body systems, with exceptions for breast, genital, or rectal exams if not indicated or refused ().
Payment Rules
• If the physician has rendered a consultation, general assessment, or general re-assessment of the patient prior to admission, the amount payable for the service will be adjusted to a lesser fee ().
• This admission assessment is considered a component of the Monthly Management of a Nursing Home or Home for the Aged Patient fee (W010) and is not separately payable if the Most Responsible Physician (MRP) claims W010 for that month (, ).
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