tci Medicare Compliance & Reimbursement - 2013 Issue 13
Reimbursement: Boost Your Bottom Line By Billing Services In Addition To Preventive Care
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Article Overview
This article is aimed at coding and reimbursement staff who want to understand when services performed during preventive care visits may also be reportable. It covers broad categories such as preventive medicine evaluation and management visits, in-office laboratory testing, hearing and vision screenings, and immunization-related billing considerations, along with the general impact of modifier use and bundling edits.
Why This Topic Matters
Preventive visits are often assumed to be all-inclusive, but some additional services may affect reporting and payment. Understanding the article helps readers identify the main service categories and compliance issues that can influence claim submission.
Article Sections
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Preventive medicine visit codes
Introduces the general approach to reporting preventive wellness visits and distinguishes the main preventive medicine code families referenced in the article.
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In-office laboratory tests
Discusses laboratory services performed during the encounter and the general billing considerations tied to office-based testing and specimen collection.
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Hearing or vision screenings
Covers screening services that may be performed during a preventive visit and the broader category of vision and hearing screening reporting.
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Immunizations
Reviews vaccine-related services given at the same time as preventive care, including administration and product reporting in general terms.
What You Will Learn
- How preventive medicine visits are generally categorized
- What types of additional services may be considered during the encounter
- How office-based testing and screening services fit into preventive care billing
- Why immunization-related claims can involve separate reporting considerations
- How modifier use and bundling edits relate to preventive care claims
Who Should Read This
- Medical coders
- Billing staff
- Revenue cycle professionals
- Physician practice managers
- Primary care practices
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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