Outpatient Facility Coding Alert - 2018 Issue 8
Reader Question: Bill Screen, not E/M, in This Prostate Scenario
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Article Overview
This reader Q&A discusses Medicare-oriented billing issues for prostate cancer screening encounters in an office setting. It focuses on how screening-related services, routine blood collection, and office evaluation and management services may be treated when they occur on the same date, and it references preventive service guidance and bundled payment concepts relevant to physicians and coding staff.
Why This Topic Matters
It helps coders and billing staff distinguish screening encounters from problem-oriented visits and understand when common office services may be separately reported or considered included in payment.
What You Will Learn
- How prostate screening encounters are discussed from a billing perspective
- Which general service categories may be considered in the same encounter
- How Medicare preventive service guidance is relevant to the scenario
- Why same-day screening and office visit billing can be limited in certain situations
Who Should Read This
- Medical coders
- Billing staff
- Physician practices
- Compliance professionals
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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