Partial Assessment

 This shall consist of the necessary history, an enquiry concerning and the necessary examination of the affected part, region or system. This includes visits for following the progress of treatment and initial visits wherein the patient’s condition does not clinically warrant a General Assessment/Reassessment, or a Specific Assessment/Reassessment. 

 Follow-up visits for monitoring the use of birth control pills qualify as Partial Assessments, with or without fee code 54614, depending on the nature of the examination performed. 

 A visit for a requested Pap Smear and/or breast examination, without other significant medical complaints or illness, qualifies as a Partial Assessment, with or without fee code 54614, depending upon the nature of the examination performed.

Partial Assessment of a Patient who is 65 to 74 Years of Age 

This is a Partial Assessment of a patient who is 65 to 74 years of age. 

 Partial Assessment of a Patient who is 75 Years of Age and Older This is a Partial Assessment of a patient who is 75 years of age and older. 

 Partial Assessment of a Patient Who Received a WHSCC Service during the Same Office Visit 

This applies when a physician performs a Partial Assessment of a patient for an MCP insured problem(s) immediately before or after examination/treatment of a problem covered by the WHSCC during the same office visit. This fee code (126) is only billable for non-WHSCC, MCP insured services and should only be billed to MCP. 

If the service provided is more extensive than a Partial Assessment (e.g. a General Assessment or Reassessment, Psychotherapy), it should be billed IC giving the reason(s) why a more extensive examination was necessary. 

Physiatric Management 

This applies to Physiatrists regulating the day-to-day management of patients, when medical necessity requires prescription development, advice and supervision. It may be billed on the days when rehabilitation services are provided to patients seen previously by the Physiatrist for consultation or assessment. This fee is not meant as an administrative fee for supervising a department of rehabilitation nor is it to be charged on the same day as claims are made for any other services which are provided by the Physiatrist to the same patient. It applies only to those patients who require and receive frequent attention by the physician during the course of rehabilitation with regard to rehabilitative services of physician and occupational therapy, speech therapy or discharge planning

Pre-Anaesthetic Clinic Assessment 

Fee code 409 is applicable for patients assessed by Anaesthesiologists in organized preanaesthetic clinics prior to surgery, including day surgery. 

 Consultation fee codes may not be claimed by an Anaesthesiologist in respect of patients assessed in an organized pre-anaesthetic clinic, regardless of referral. 

 This visit code is not payable in addition to another consultation or assessment performed by the same Anaesthesiologist prior to surgery.