decisionhealth Newsletters, Part B News - 2003 Issue 5 (May)
PBN Special Report: See when you can bill screening services
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Article Overview
This article reviews a set of Medicare screening and preventive services that may be payable under specific patient and frequency criteria. It is useful for coders, billers, compliance staff, and practice administrators who need a broad understanding of which screening categories are addressed and how the article is organized by service type, without exposing the premium details.
Why This Topic Matters
Coverage for screening services depends on service type, patient population, and timing rules. Understanding which preventive services are discussed helps readers quickly determine whether the full article is relevant to their billing and compliance needs.
Article Sections
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Bone-mass measurements
Discusses Medicare coverage of bone-density screening and the general patient categories addressed in the article. Also introduces the related imaging code set references.
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Colorectal cancer screening
Summarizes the preventive colorectal screening topic, including the broad Medicare coverage categories and high-risk context covered in the article. Includes the related test and procedure code references.
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Definition of high risk
Lists the general risk-factor framework used in the colorectal screening discussion. This section supports understanding of the coverage context without providing detailed decision logic.
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Diabetes self-management training
Covers Medicare coverage considerations for diabetes education and training services. The section identifies the broad patient and program requirements referenced by the article.
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Glaucoma screening
Addresses glaucoma screening coverage for Medicare beneficiaries at elevated risk and the general provider context described in the article. Includes associated code references.
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Mammogram screening
Reviews the mammography screening topic and the age-based Medicare coverage categories mentioned in the article. Includes the related screening code references.
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Pap test and pelvic exam (including breast exam)
Summarizes preventive gynecologic screening coverage and the broad timing categories discussed in the article. Includes the linked screening service code reference.
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Prostate cancer screening
Covers the Medicare prostate screening topic and the general beneficiary criteria referenced in the article. Includes the associated exam and lab code references.
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Immunizations
Discusses preventive immunization coverage categories included in the article and the general vaccine administration context. Includes the referenced administration code set.
What You Will Learn
- Which preventive screening service categories are discussed in the article
- How the article groups Medicare-covered screening topics by service type
- Which code sets are referenced for the screening and immunization topics
- What broad eligibility and frequency themes are covered for each preventive service category
- Which organizations and policy references are mentioned as the basis for the coverage discussion
Who Should Read This
- Medical coders
- Billing staff
- Compliance professionals
- Revenue cycle teams
- Practice administrators
- Healthcare office staff
Codes Discussed
Code Ranges Discussed
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