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W448
W448 – Subsequent visits per month (maximum of 3 per patient per month) - Nursing home or home for the aged
OHIP Neurology Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A subsequent visit rendered by a physician with the specialty of Medical Oncology (44) for a patient in a nursing home or home for the aged. This service is defined as any routine assessment following the patient’s admission to a long-term care institution. See for general rules on subsequent visits in long-term care institutions. For emergency calls and other special visits to in-patients, use General Listings ('A' prefix) and Premiums when applicable.
When to Use
- Use W448 for routine follow-up assessments of a nursing home patient by a Medical Oncologist when the physician is not acting as the Most Responsible Physician (MRP) for monthly management.
- Use W448 when providing oncology-specific monitoring for a long-term care patient who is already managed by a primary care physician billing W010.
Common Pitfalls
- Billing W448 in the same month as W010 by the same physician will trigger an automatic rejection or recovery, as W010 is intended to encompass all routine subsequent visits.
- Attempting to attach special visit premiums to W448 will result in rejection; use an 'A' prefix assessment code instead if the visit is urgent or non-elective.
Billing Tips
- Ensure you do not exceed the maximum of three W448 claims per patient per month, as subsequent visits beyond this limit are not eligible for separate payment.
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