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Wiki Billing a preventative visit when pap not done

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sgormsen

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My physicians are following the guidelines in which a Pap is done every two years. Here's my delima. If a pap/pelvic exam is not done and just a breast exam, then it's my interpretation that this is just an Office visit 99213- 99215 and not the preventative E & M codes. My docs say that they can bill for example a 99395 with V76.2 & V72.31 because they are following these guidelines even though in the chart note under "genitalia" it says "Not Needed". If they are doing the pap/pelvic exam every 2 years then they should only be billing the preventative exam codes every two years. If I'm correct and I think I am, where can I find documentation to present to my Docs? Any help would be greatly appreciated.
thanks,
susan G
 
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