decisionhealth Newsletters, Coder Pink Sheets - 2006 Issue 12 (December)
Strategies for billing for medical records reviews
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Article Overview
This article explains how medical record review time is handled in billing discussions, with emphasis on when review may be considered part of an evaluation and management encounter and when it is typically not separately payable. It also covers rare paid scenarios involving legal and school-related record reviews. The piece is aimed at physicians, pediatric practices, office managers, and coding/billing staff who need to understand the general scope of reimbursement for record review activities.
Why This Topic Matters
Medical record review is a frequent administrative and clinical task, but payment rules are limited and often misunderstood. Understanding the broad categories of payable versus nonpayable situations can help practices avoid incorrect billing and identify unusual circumstances where separate arrangements may exist.
What You Will Learn
- How medical record review time is discussed in relation to patient counseling and encounter time
- Which broad situations are described as uncommon exceptions for payment
- How legal and school-related record review arrangements are characterized at a high level
- Why practices may need to distinguish chart review from separately billable services
Who Should Read This
- Physicians
- Pediatricians
- Practice managers
- Medical billers
- Medical coders
- Revenue cycle staff
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