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W992
W992 – First person seen - Weekdays Evenings
OHIP Neurology Code — GENERAL PREAMBLE · Schedule of Benefits
This is a special visit premium, payable for the first patient seen at a Long-Term Care Institution. The visit must be non-elective and occur on a weekday evening between 17:00 and 24:00. This premium is claimed in addition to an appropriate assessment fee from the 'General Listings' (A-prefix codes). See through for full rules on special visits.
When to Use
- Use W992 when you are called to a Long-Term Care facility for an urgent, non-elective assessment of a patient between 17:00 and 24:00 on a weekday.
- Use this code when you are already at the facility for an urgent visit and see a first patient, provided the visit was not pre-scheduled or elective.
Common Pitfalls
- Claiming W992 for routine, pre-scheduled medication reviews or annual physicals, which are considered elective and ineligible for special visit premiums.
- Billing W992 alongside a subsequent visit code (e.g., W002) instead of the required A-prefix assessment code (e.g., A007) from the General Listings.
- Failing to document the exact start time of the visit, which is a mandatory requirement for audit compliance under GP69.
Billing Tips
- Always pair W992 with the appropriate A-prefix assessment code and, if you see subsequent patients during the same trip, append W993 for each additional patient.
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