W462 – Infectious disease chronic care or convalescent hospital - first 4 subsequent visits per patient per month
OHIP Neurology Code — CONSULTATIONS AND VISITS · Schedule of Benefits
W462 represents one of the first four subsequent visits per patient per month, rendered by a specialist in Infectious Disease (46) in a chronic care or convalescent hospital setting. A subsequent visit is a routine assessment following the patient's admission to a long-term care institution, as defined in the General Preamble (). Additional subsequent visits beyond the fourth are claimed using W461.
When to Use
- Use W462 for the first four routine follow-up assessments per month when providing specialized infectious disease management in a chronic care or convalescent facility.
- Select W462 when the patient requires ongoing monitoring of chronic infections, such as long-term antibiotic therapy or wound management, within an institutional setting.
Common Pitfalls
- Billing W462 in the same month as W010 will trigger an automatic rejection, as subsequent visits are considered included in the monthly management fee.
- Claiming W462 beyond the fourth visit in a single month is a common error; any visits from the fifth onwards must be billed under W461 to avoid payment discrepancies.
Billing Tips
- Ensure your billing software tracks the monthly count of institutional visits to automatically switch from W462 to W461 once the four-visit threshold is exceeded.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Assessment
Hospital and Institutional Consultations and Assessments
May only be claimed 6 months after Periodic health visit (as per the Nursing Homes Act).
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