Exactly what is and is not covered or to be discussed during a routine physical so as not to trigger additional charges?
The free preventive visit under ObamaCare covers routine wellness and prevention, it may not cover discussion of existing conditions and other asides. You can see a full list of all preventive screenings and immunizations here, but we haven't been able to find a "full list" of everything considered preventive /wellness and everything considered "other".
Basically it works like this, your doctor has one annual visit to catch things before they become a problem. That may be helping you to book immunizations, it may be discussing diet, it may be basic check-up stuff, it may be setting up a cancer screening. All of this prevention, along with the basic checkup stuff, is coded as an "annual wellness visit".
If your doctor finds that you have an ear infection while checking your ears, they probably won't charge... but technically they could as you would have known you had an ear infection. Therefore treating the preexisting condition isn't preventive it is a treatment. How does your doctor code? This is up to your doctor. Do they let something slide, do they consider it preventive, or do they put their foot down as they have a lot of preventive visits to do today and each takes time.