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W461 – Chronic care or convalescent hospital - additional subsequent visits

OHIP Consultations and Visits Code — CONSULTATIONS AND VISITS · Schedule of Benefits

This service represents an additional subsequent visit to a patient in a chronic care or convalescent hospital, rendered by a specialist in Infectious Disease (46). It is applicable for the fifth and sixth visits within a single month, following the initial four visits which are claimed using W462. A subsequent visit is a routine assessment following the patient's admission to a long-term care institution, as defined in . The total number of routine subsequent visits per patient, per month (a combination of W462 and W461) is limited to a maximum of six.
As per , all assessments require a direct physical encounter with the patient, including a patient history and physical examination, with appropriate documentation in the medical record.

May only be claimed 6 months after Periodic health visit (as per the Nursing Homes Act).

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