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.
