Fee codes 118 and 418 must be claimed by General Practitioners who provide routine postoperative
care to patients during the 42-day post-operative period.
Specific Assessment
This shall consist of a full history of the presenting complaint, enquiry concerning, and
detailed examination of the affected part, region or system as needed to make a diagnosis,
exclude disease and/or assess function and advice to the patient.
Not more than one major examination (Consultation, General Assessment, or Specific
Assessment) per patient per physician may be claimed within a 90-day period regardless of
diagnosis and referring source, except in cases of true emergency. Such claims must be
submitted IC clarifying the nature of the emergency.
Specific Reassessment
This shall consist of a full relevant history and examination of one or more systems of a
patient not requiring a comprehensive evaluation of the patient as a whole.
Specific Reassessments apply in the ongoing management and assessment of disease and
for following the progress of treatment.
The second and subsequent Specific Assessments on a patient within each 90 days should
be claimed as Specific Reassessments.
Follow-up visits for monitoring the use of birth control pills qualify as Specific
Reassessments, 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 Specific Reassessment, with or without
fee code 54614, depending upon the nature of the examination performed.
