W667 – Neurodevelopmental consultation
OHIP Neurology Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A neurodevelopmental consultation provided by a paediatrician for a non-emergency in-patient in a long-term care institution. This service is explicitly subject to the same conditions as A667. According to the Schedule (, ), the 'W' prefix designates services for patients in specific non-emergency, long-term care settings, including chronic care hospitals, convalescent hospitals, nursing homes, and homes for the aged. As a consultation, this service requires a written request from a referring practitioner and a subsequent written report from the consultant, as detailed in .
When to Use
- Use W667 for a scheduled neurodevelopmental assessment of a paediatric patient residing in a chronic care hospital or nursing home when a formal written referral is present.
- Use this code for non-emergency consultations in long-term care settings where the patient requires a specialized neurodevelopmental review that does not meet the criteria for an acute care 'A' prefix consultation.
Common Pitfalls
- Billing W667 for patients in acute care hospitals; 'W' codes are strictly for long-term care institutions, whereas 'A' codes (like A667) must be used for acute care settings.
- Failing to document the start and stop time in the medical record, which triggers an automatic reduction of the fee to a lower assessment code.
- Exceeding the 12-month frequency limit, which results in the claim being automatically adjusted to a lower assessment fee.
Billing Tips
- Ensure the written referral is clearly labeled as a consultation request, as missing or ambiguous documentation will cause the claim to be downgraded to a lower-paying visit code.
- Always apply the appropriate age-based premium to the W667 base fee, as these are not automatically calculated and must be submitted as separate line items or adjusted amounts depending on your billing software.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Consultation
Consultations, Hospital and Institutional Consultations and Assessments
A copy of the written request for the consultation, signed by the referring practitioner, must be kept in the consultant's medical record. In settings with a common medical record (e.g., long-term care institution), the request may be on the common record. ()
The request must identify the consultant by name, the referring practitioner by name and billing number, and the patient by name and health number. ()
The written request must set out the information relevant to the referral and specify the service(s) required. ()
The consultant must prepare a written report including findings, opinions, and recommendations for the referring practitioner. ()
The start and stop time must be recorded in the patient’s permanent medical record or the payment for this service will be reduced to a lesser fee. ()
infant, child or adolescent
Subject to same conditions as A667.
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