decisionhealth Newsletters, Answer Books - 2009 Issue 2 (February)
Physical Examinations-Histories / What You can Charge the Patient
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Article Overview
This short Find-A-Code article addresses how charges may be handled when part of a visit is covered and part is not, with emphasis on Medicare and routine physical examinations/histories. It is relevant to coders, billing staff, and compliance personnel who need a general understanding of coverage-based billing distinctions and patient charge practices.
Why This Topic Matters
Understanding the billing treatment of covered versus non-covered services helps reduce claim and patient-account errors and supports compliance with Medicare coverage rules.
What You Will Learn
- How the article frames patient charges when a visit includes covered and non-covered components.
- How Medicare coverage context affects billing considerations for routine physical examinations and histories.
- What general billing and notice-related issues are discussed for this type of visit.
- What types of compliance considerations are associated with non-covered portions of a covered visit.
Who Should Read This
- Medical coders
- Billing staff
- Practice managers
- Compliance personnel
- Revenue cycle teams
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