W847 – Admission assessment - Type 3
OHIP Neurology Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A Type 3 admission assessment is a general re-assessment of a patient who is re-admitted to the long-term care institution after a minimum 3 day stay in another institution. A general re-assessment includes all the services listed for a general assessment, with the exception of the patient's history, which need not include all the details already obtained in the original assessment. This service applies to patients in chronic care hospitals, convalescent hospitals, nursing homes, homes for the aged, and designated chronic or convalescent care beds in hospitals, other than patients in designated palliative care beds. For emergency calls and other special visits to these in-patients, use General Listings and Premiums when applicable.
When to Use
- Use W847 when a patient returns to your long-term care facility after an acute care hospitalization lasting at least 72 hours.
- Use this code for a comprehensive re-assessment when the patient's clinical status has changed significantly following a transfer from another institution.
Common Pitfalls
- Billing W847 on the same day as W010 will result in a rejection, as monthly management fees are inclusive of admission assessments.
- Exceeding the limit of two W847 claims per 12-month period will trigger an automatic reduction to a lower assessment fee, impacting your expected revenue.
- Failing to document the minimum 3-day duration of the external hospital stay in the patient's chart creates a high risk for audit recovery.
Billing Tips
- Ensure the patient's chart clearly notes the discharge date from the previous institution to verify the 3-day threshold required for W847 eligibility.
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