This information conflicts with the information in Medicares Local Medical Review Policy, effective Jan. 1, 1999. It says, Code Q0091 refers to preparing and conveying a screening Pap smear to the laboratory. This code is reimbursable ONLY when it is the sole service provided during the encounter. Please let me know which of the above statements is correct.
Seattle OB/GYN Group
Answer: Per the Medicare Correct Coding Initiative, effective April 1, 1999, Q0091 (screening Papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory) may be billed with a separately identifiable evaluation and management (E/M) service on the same day, if performed by the same physician. Modifier -25 should be appended to the E/M service. Of course, its still a good idea to verify this information with your local carrier.