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Pre-existing Condition (PEC)

Medical billing & coding glossary · all terms

Definition. A health condition that existed before new coverage began. Most ACA-compliant health plans cannot deny coverage or charge more because of it, but rules for other products may differ.

You'll come across Pre-existing Condition (PEC) while working the revenue cycle — from eligibility and claim submission to payment posting and denials. See the related terms below, or browse the full glossary and the Knowledge Hub.

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