Understanding What is Covered with Code CPT 99204

One thing that most people rarely, if ever, consider when it comes to their medical examinations is what sort of code should be used to be certain that Medicare actually covers the visit.  For instance, CPT 99204 is a code that will cover you for office and outpatient evaluations of up to 45 minutes.  The codes beginning with 9920 are generally quite similar, with the primary difference being the amount of time that is spent in the evaluation.  You always need to be sure that you are choosing the correct code for the nature of the visit that you are having.  You can also get help from a billing specialist if you are not sure, and this is something that is generally recommended if you do not want to end up stuck with extra paperwork, billing issues, or waiting to be recompensed when the visit should have been covered from the very beginning. 

CPT 99204

According to these codes, the most important criteria when it comes to coverage is the fact that it is an absolute medical necessity.  If it is something that is not necessary for your personal health, you might end up having to pay out of pocket for the expenses involved.  There are many different things that your medical provider will have to consider in regards to all of your visits, including whether or not this is something that is absolutely necessary.  Being educated on these sorts of things yourself can’t hurt you and can really only help you in the long run.  By understanding your Medicare coverage, you will be able to avoid hassles and avoid out of pocket expenses.  For those of us who are receiving Social Security and do not have a whole lot of money to go around, this is absolutely essential to making sure that we are medically covered while also not losing the shirts off of our backs in the process.

No one ever said that growing old is easy, but systems like Medicare are there to help us as we age so that we do not end up suffering from serious health problems.  The bottom line is that understanding the full extent of your coverage will really help you to avoid any future problems with your personal health and your finances.  It is not always just as simple as showing up to the doctor and being treated or evaluated; you will also want to make sure that the finances are taken care of properly if you do not want to be stuck with some shocking surprises.

Luckily, most of us will have medical providers who are competent enough to make sure that all of the expenses are fully covered by our Medicare.  Of course, errors do happen from time to time, and that is why being fully educated on the subject is something that most of us really ought to do.  Understanding how the system works is something that can protect you now and in the future.