Wiki How do you bill a well woman GYN visit to medicare?

[jazmine29]

How do you bill a well woman GYN visit to medicare? They don't accept well visit codes for this type of service.

 

[mitchellde]

for Mcare well woman you go to the HCPC II book for Q and the G code for pap and breast exam and us the V72.31 dx code if your patient has no cervix then add a V 76.47 and the appropriate V88.xx code.

 

[jazmine29]

What about the E/M visit? Can this be billed as a 99214? G0101 covers cervical or vaginal cancer screening; pelvic and clinical breast exam. Q0091 covers pap.
What about the rest of the visit?
Thank you!!!!

 

[andyrobin]

Example
9939_ Normal charge 190.00
minus g0101 charge ......35.00
minus q0091 charge........42.00

You charge 113.00 for the 9939_ preventative visit. Be sure to have the patient sign an ABN if this is a new visit or if the patient has had a preventative visit the year before and does not have a high risk diagnosis for the screening and pelvic exam codes. The patient is responsible for the preventative part of the visit as medicare does not pay for this.

Hope this helps.

Robin King, CPC