A313 – Medical specific assessment

A medical specific assessment is a service rendered by a specialist in a place other than a patient's home. It requires a full history of the presenting complaint and a detailed examination of the affected part(s), region(s), or system(s) needed to make a diagnosis, and/or exclude disease, and/or assess function. In addition to the common elements, all services described as assessments, or as including assessments (e.g. consultations), include the following specific elements as per GP15: A. A direct physical encounter with the patient including taking a patient history and performing a physical examination. B. Other inquiry (including taking a patient history), carried out to arrive at an opinion as to the nature of the patient's condition, (whether such inquiry takes place before, during or after the encounter during which the physical examination takes place) and/or follow-up care. C. Performing any procedure(s) during the same encounter as the physical examination, unless the procedure(s) is(are) separately listed in the Schedule and an amount is payable for the procedure in conjunction with an assessment. D. Making arrangements for any related assessments, procedures or therapy, and/or interpreting results. E. Making arrangements for follow-up care. F. Discussion with, and providing advice and information, including prescribing therapy to the patient or the patient's representative, whether by telephone or otherwise, on matters related to the service and results. G. When medically indicated, monitoring the condition of the patient and intervening, until the next insured service is provided. H. Providing premises, equipment, supplies, and personnel for the specific elements of the service except for any aspect(s) that is (are) performed in a hospital or nursing home.