• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below..
  • Important Note: We will be performing a scheduled maintenance on 1st November 2020. The site will be offline from 7:30PM (MT) till midnight. We apologize for any inconvenience this may cause.

Annual Gyno Exam Coding


Best answers
I do the billing for a family practice group and they are requesting we bill each insurance differently for the annual gyno exams.
They're requesting we bill:
Medicare Patients as G0101 & Q0091
Blue Cross Patients as S0612 & Q0091
All other Insurances as the 99 preventitive code and the Q0091.

Is it acceptable to bill 3 different ways for the exact same procedure?

At times the commercial payers are denying the Q0091, can the patients be billed for the pap collection?

Thanks in advance for any advice:)
Lady Lake, FL
Best answers
Here is the correct way to bill Medicare: 993xx-GY, G0101-GA, Q0091-GA
Modifier GY indicates, that this is a non-covered Medicare Service submitted for secondary consideration. Modifier GA indicates that a Medicare ABN has been obtained (provided that all criteria has been met at tos).

Regarding commercials, submit the services according to their guidelines. Blue Shield has always been a class on its own regarding coding. Many comercials consider that the Q0091 is bundled within the 993xx and according to many insurance contracts, inappropriate to bill the patient. It's always recommended to know coding/billing requirements for all carriers.