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W662

W662Extended special paediatric consultation

OHIP Neurology Code — CONSULTATIONS AND VISITS · Schedule of Benefits

An extended special paediatric consultation rendered to a non-emergency patient in a Long-Term Care Institution (Chronic Care Hospital, Convalescent Hospital, Nursing Home, Home for the Aged, or designated chronic/convalescent care beds). This service is a consultation requested by a referring provider due to the complexity, seriousness, or obscurity of the case, or at the patient's request. It is subject to the same conditions as A662. As per the General Preamble, a consultation requires a written request from a referring physician, nurse practitioner, or dental surgeon, and the consultant must provide a written report back to the referring practitioner. The service includes all common and specific elements of an assessment as outlined in -.

When to Use

  • Use W662 when providing a comprehensive consultation for a pediatric patient residing in a long-term care facility, such as a chronic care hospital or nursing home, where the complexity requires an extended assessment.
  • Select W662 instead of A662 when the service location is specifically a designated chronic or convalescent care facility, as W662 is the institutional equivalent for pediatric consultations.

Common Pitfalls

  • Failing to record the exact start and stop times in the medical record is a frequent cause of audit recovery, as this is a mandatory requirement for all extended consultation codes.
  • Billing W662 for a patient who has reached their 18th birthday will result in an automatic rejection, as this code is strictly limited to pediatric patients under 18.
  • Assuming a verbal request is sufficient; like A662, W662 requires a formal written request from the referring practitioner to be present in the patient's chart to support the claim.

Billing Tips

  • Ensure you append the appropriate age-based premium (e.g., 5-16 years) to the W662 base fee to maximize the claim value, as these are eligible add-ons for this code.
  • Verify that your written report to the referring physician is dated and clearly outlines the findings and recommendations, as this documentation is essential to justify the 'extended' nature of the consultation during an audit.
Provider Fee$0.00
Specialist Fee$401.30

Effective: June 1, 2025

Category

A. Consultations and Visits

Subcategory

CONSULTATIONS AND VISITS

Service Type

Consultation

Code Classes

Consultations, Hospital and Institutional Consultations and Assessments

Referral RequiredFrom: Physician, NursePractitioner, DentalSurgeon

A copy of the written request for the consultation, signed by the referring physician, nurse practitioner or dental surgeon must be kept in the consulting physician's medical record. In a facility with a common medical record, the request may be on that record.

The request identifies the consultant by name, the referring physician, nurse practitioner or dental surgeon by name and billing number, and identifies the patient by name and health number.

The written request sets out the information relevant to the referral and specifies the service(s) required.

The consultant is required to prepare a written report (including findings, opinions, and recommendations) to the referring physician, nurse practitioner or dental surgeon.

The service is eligible for payment only if start and stop times of the service are recorded in the patient's permanent medical record.

Age Restriction

Patient must be under 18 years of age

Subject to the same conditions as A662.

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