I just found out that a doctor's office can bill two billing codes for the same 15 minutes of time.  I am a 47-year old woman.  My annual gynecological exam is supposed to be cover under my insurance.  For my annual exam which involves about 15 min of the practitioner's time, I was billed 2 office visits for the same 15 min.

1)  It was billed as my annual exam: $190

2)  It was also billed as an office visit (not covered): $150

So, for my annual exam I ended up having to pay $150 that went towards my deductible.  I called the office and they said, yes if they find something – then it’s not just an annual exam.  Then it’s an office visit as well.

However, isn't that what an annual screening visit is for - to see if they feel anything?  If they find a lump on a digital rectal exam for prostate screening is that then billed as 2 office visits? During this 15 min exam, the practitioner didn’t ‘do anything’ that would not  be involved in an annual exam except write a prescription to go get more screening- ultrasounds - as she did feel breast lumps and uterine fibroids, both of which I have a documented history of.  The office said if they find anything of concern, and they refer you to subsequent services - then it’s no longer a screening/annual exam.  It has now become an office visit.  Thus, the exam is billed solely as an annual exam as long as they don't find anything of concern.  I do not feel that is ethical or is consistent with the goal of an 'annual preventative health screening visit'. 

I feel strongly that a recommended yearly annual preventative health screening exam that is supposed to be covered by insurance should be billed as just that (and thereby completely covered) rather than potentially also billed as an office visit if they find anything of concern.