Wiki 2nd plea for help, well woman exam's


Fallbrook, CA
Best answers
When a OBGYN is doing a well woman exam on a patient how is the best to code this. Sometimes they just come in for a "pap" only, we use G0101/V72.31. If they discuss contraceptive options or maybe hormone replacement, or other "female" problems, how is the best to code these. Can we use the G0101 for the pap and an E/M code for the other "female" problems eg: 627.2,V07.4,616.10. our billing department says if the problems are "female" related it should all be covered under the G0101. The insurance company's say it is all "related to the G0101 female exam. This doesn't seem fair if the doctor is spending extra time talking about other "female" issues. Someone had said that the G0101 is for medicare patients only. That is not my understanding. Especially now with digital mammo's those codes are only G-codes. Also can the OBG doctor bill for the "physical codes like 99395" or what all would need to be in his notes re: the physical? Thank you sorry so long.
Check the CCI edits to see if the codes can be coded together and refer to the guidelines to see what they say. Each policy is so different, you really have to check what they will allow.

Good luck!