decisionhealth Newsletters, Answer Books - 2009 Issue 1 (January)
Answer_Book / Physical_Examinations_Histories / o
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Article Overview
This article explains how Medicare generally treats routine physical examinations, how coverage may differ when a medically necessary service is provided at the same time, and how certain tests performed during a visit are addressed. It is useful for clinicians, coders, billers, and compliance staff who need a high-level understanding of which parts of a visit may be covered versus non-covered under Medicare policy.
Why This Topic Matters
Understanding the coverage distinction for physical examinations and related services helps support correct reporting, patient billing, and avoidance of improper denial or payment assumptions under Medicare.
What You Will Learn
- How Medicare generally views routine physical examinations
- How concurrent medically necessary care affects visit coverage
- How screening and diagnostic tests performed during a visit are discussed in a Medicare context
- How non-covered portions of a visit may be handled from a billing standpoint
Who Should Read This
- Medical coders
- Physician office billers
- Compliance professionals
- Clinical practice administrators
- Healthcare providers
Codes Discussed
Code Ranges Discussed
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