CARC · PR group
PR-49
Routine examination or screening procedure with a routine exam
Patient responsibility; billable to the patient
- What it means
- The payer treated the service as routine screening not covered under the plan.
- Likely cause
- Screening or wellness-style codes billed without a covered diagnosis or benefit.
- How to fix it
- Confirm whether preventive behavioral screening is a covered benefit; if not, disclose and bill the patient.
- Revenue impact
- Usually patient responsibility once properly disclosed.
- screening
- non-covered
- patient responsibility
Related codes
Early access
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