Wiki medicare coding

[nikkigrimjordan@aol.com]

Working for a gyn office, patient has medicare, patient came in for annual well woman exam and lichen follow up. Dr coded the exam 99213,25 and 99397,GX G0101,GA, is this correct? For annual well-woman exams at a specialist GYN office how do you bill. I am aware of the carve out rule. Want to bill correctly.

 

[nielynco]

Working for a gyn office, patient has medicare, patient came in for annual well woman exam and lichen follow up. Dr coded the exam 99213,25 and 99397,GX G0101,GA, is this correct? For annual well-woman exams at a specialist GYN office how do you bill. I am aware of the carve out rule. Want to bill correctly.

Technically yes, but I would question as to whether the pelvic exam was performed as a screening under Medicare guidelines that she is eligible for in the covered year, or was done to exam her for the follow-up due to the lichens. If done for lichens, you should not be also counting the exam towards Medicare requirements or vice-versa.