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Collection of Pap Smear and E/M Visit on Same Day

J

JCampbell

Guru
Messages
165
Location
Chester, IL
If a patient comes in for a repeat pap is it appropriate to bill both an e/m visit and collection of specimen (Q0091)? We have billed both and are receiving a denial from the insurance stating that the e/m is being bundled with the Q0091. I know that a 25 modifier will unbundle the service but am uncertain on using this modifier for this particular situation.


Thanks for any help that you may be able to give.

Jennifer
 
If they are being seen for a separate issue in addition to the repeat pap, then yes you can bill the E/M and add -25 modifier, but if the repeat pap is the only reason, then bundling is correct.
 
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