W775 – Comprehensive geriatric consultation
OHIP Neurology Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A comprehensive geriatric consultation rendered following a written request from a referring practitioner for a patient in a non-emergency long-term care setting (e.g., chronic care hospital, nursing home). It is subject to the same conditions as general listing consultation A775. As a consultation, it requires a direct physical encounter, including a full history and examination appropriate to the patient's condition, to provide an opinion. The service includes all constituent elements of an assessment as outlined in , such as reviewing data, arranging further tests, and providing advice. A written report with findings and recommendations must be sent to the referring practitioner. See for full consultation requirements.
When to Use
- Use W775 for a comprehensive geriatric assessment in a long-term care facility or chronic care hospital when a written referral is received from a physician, nurse practitioner, or dental surgeon.
- Use this code when the patient requires a full geriatric evaluation (e.g., cognitive, functional, and medication review) that exceeds the scope of a standard W075 or W375 assessment.
Common Pitfalls
- Billing W775 for an emergency call or urgent visit; these must be billed using A775 with the appropriate special visit premium.
- Failing to ensure the written referral specifically requests a consultation, which can lead to a downgrade to a lesser assessment fee during an audit.
- Submitting W775 without a corresponding written report sent to the referring practitioner, as this is a mandatory requirement for all consultation codes.
Billing Tips
- Ensure the referring practitioner's name and billing number are clearly documented in your clinical note to satisfy the referral requirements for institutional consultations.
- If you provide psychotherapy on the same day, ensure the clinical record clearly distinguishes the geriatric consultation from the psychiatric service to avoid rejection.
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 physician, nurse practitioner or dental surgeon must be kept in the consulting physician's medical record, except in the case of a consultation which occurs in a hospital, long-term care institution or multi-specialty clinic where common medical records are maintained. In such cases, the written request may be contained on the common medical 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 must prepare a written report (including findings, opinions, and recommendations) to the referring physician, nurse practitioner or dental surgeon.
Subject to the same conditions as A775.
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