Definition

Services or items that your insurance does not pay for. These charges appear on your bill as amounts you must pay out of pocket.

What to consider

  • Verify the code matches the service received.
  • Understand that codes are used for billing and insurance claims.
  • Ask for clarification if the code seems unfamiliar.

Real world scenarios

  • After surgery, Michael’s bill included a specific procedure code for the operation performed.
  • Susan’s outpatient visit was documented with a unique procedure code on her invoice.
  • A specialist explained that the procedure code helps standardize billing across providers.

Related terms

Healthcare