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Wiki GYN coding help

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bedforak1

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I have never coded GYN before, so please please help me :) I have a new patient that came in and her E/M scored out to be a 99202. My doc also did a pap smear. Is it appropriate to code 99202-25 and Q0091?
 
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It depends

You can if the patient came in for a preventive exam and she asked the doctor about a problem while she was there then you can charge the E/M problem code with a 25 modifier attached. Or if the patient comes in for a repeat pap then you would charge the office visit code with a 25 modifier and the pap collection code. If the patient is scheduled to come in for a gyn problem then most insurance companies will see the pap collection as part of the E/M code and will not pay for the collection fee.
 
In Pennsylvania we can't use Q0091 unless it is Medicare. All other insurances include the Pap with the preventive exam and use V76.2 dx.
 
You can bill the E&M (99213) with a Modifier 25. Usually the insurance companies won't pay for the pap collection unless it is being billed as a screening (V76.2, V74.5.) Also, the only insurances that usually require the Q code is Medicare and straight Medicaid that I am aware of. All other insurances you would use 99000. I hope this helps!

Cassie, CPC
 
Gyn-oncology

Good Morning! Can anyone please tell what is the correct code or if there is a code for Evacuation of Foreign body? Thank you.
 
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