Medicare Contractors: Hold Off on Q0091 Claims

Contributed by Belinda Frisch, CPC, E/M

If you want to get paid for screening pap smears in a timely fashion, you might want to hold off on submitting claims for services rendered to Medicare patients.

Effective immediately, the Centers for Medicare & Medicaid (CMS) has instructed their contractors to hold all Outpatient Prospective Payment System (OPPS) claims containing HCPCS Level II code Q0091 Screening Pap Smear, obtaining, preparing, and conveyance of cervical or vaginal smear to laboratory until Jan. 5, 2009, at which time the necessary changes to the Outpatient Code Editor will be successfully implemented.

The option is to not submit code Q0091 to avoid delay in reimbursement for other services submitted on the claim.

Interest will be paid on all clean claims held longer than 30 days following receipt of the claim.


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