W930 – Uveitis and ocular inflammatory diseases consultation
OHIP Neurology Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A consultation for uveitis and ocular inflammatory diseases rendered to a patient in a long-term care facility, such as a chronic care hospital, convalescent hospital, nursing home, or home for the aged, as defined on . This service is subject to the same conditions as A930. As a consultation, it requires a written request from a referring practitioner and involves a comprehensive assessment to provide an opinion and recommendations, which are then reported back in writing. It is not payable for patients in designated palliative care beds.
When to Use
- Use W930 when performing an initial consultation for uveitis or ocular inflammatory disease specifically for a patient residing in a long-term care facility or chronic care hospital.
- Use this code instead of A930 when the patient location is an institutional setting defined under A150, as W930 is the designated institutional equivalent for this specialty service.
Common Pitfalls
- Billing W930 for patients in designated palliative care beds will result in rejection, as these are explicitly excluded from the institutional consultation fee schedule.
- Failing to document a formal written referral from a physician, nurse practitioner, or dental surgeon will lead to audit recovery, as W930 requires the same strict referral documentation as A930.
- Billing W930 more than once per patient per 12-month period without a new written referral for a different diagnosis will result in the claim being downgraded to a general assessment fee.
Billing Tips
- Ensure the referring practitioner's name and billing number are clearly recorded in your chart to satisfy the documentation requirements for a valid consultation claim.
- Always append the appropriate age-based premium code if the patient qualifies, as W930 is eligible for the same percentage-based increases as A930.
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.
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 is required to prepare a written report (including findings, opinions, and recommendations) to the referring practitioner.
Uveitis and ocular inflammatory diseases consultation subject to the same conditions as A930.
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