W982 – Palliative care
OHIP Neurology Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A palliative care subsequent visit is a routine assessment rendered by a specialist providing palliative care to a patient in a long-term care institution (chronic care hospitals, convalescent hospitals, nursing homes, homes for the aged, and designated chronic or convalescent care beds). Palliative care is defined as care provided to a terminally ill patient in the final year of life where the decision has been made that there will be no aggressive treatment of the underlying disease and care is to be directed to maintaining the comfort of the patient until death occurs. This service includes all the specific elements of an assessment as outlined in . Visits for acute intercurrent illnesses should be billed as W121 or, if a special visit is required, using an appropriate 'A' prefix assessment with special visit premiums.
When to Use
- Use W982 for routine comfort-focused assessments of terminally ill patients in long-term care facilities who are not in designated palliative care beds.
- Use this code for ongoing palliative management when the patient's care plan has shifted away from curative treatment for their underlying terminal condition.
Common Pitfalls
- Billing W982 for acute intercurrent illnesses, such as a new infection or injury, which must be billed as W121 instead.
- Using W982 for patients in designated palliative care beds, which requires the use of C882 or C982 instead.
- Attempting to attach special visit premiums to W982, which is prohibited; use an 'A' prefix assessment code if a special visit is required.
Billing Tips
- Ensure documentation explicitly reflects the palliative nature of the visit and the shift to comfort-directed care to justify the use of W982 over standard institutional visit codes.
- Verify the patient's bed status before billing, as the designation of the bed takes precedence over the facility type when choosing between W982 and C882/C982.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Assessment
Hospital and Institutional Consultations and Assessments
In accordance with the Health Insurance Act, the medical record must establish that an insured service was provided, the service for which the account is submitted is the service that was rendered, and the service was medically necessary. See .
As an assessment, the service must include the specific elements outlined in , including a direct physical encounter, history, examination, and appropriate record-keeping.
Services rendered to patients whose unexpected death occurs after prolonged hospitalization for another diagnosis unrelated to the cause of death do not constitute palliative care assessments.
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