MEDI-CAL - Well Woman Exam CPT Codes

ashokie

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HI ALL,

We are based in Southern California, and Medi-Cal is giving us a hard time with the Well Woman Exam codes. G0101 (with Medicare) is not an accepted code.

Our best guess was to do an E&M Code with an 88150 for Pap. We've been trying to figure this one out - Please help!

Thanks! :confused:
 

mitchellde

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you charge a preventive E&M you do not charge the 88150 that is for the lab to charge. you use the V72.31 dx code if you also perform a cervical pap you do not add the V76.2 it is inclusive, however if you patient has had a hysterectomy you do add a V76.47 for the vaginal pap, along with the V88.xx code.
 

ashokie

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Thank you Debra for your reply and help.

Medi-Cal does not accept preventative E&Ms (ie 99385-87 and 99395-97) Was that what you are referring to? Do you know of other procedure codes?
 

mitchellde

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do they not accept them or not cover them? when I worked there they were not covered except for well child. You need to find out from MediCal if preventive well woman is a covered benefit. I cannot imagine that they want you to use a regular OV level .. but it IS MediCal!
 

bpoae1

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I have a question is it a "law" in Michigan that you have to be a certified CPT coder? there is a girl in the office I work that is a medical assistant and she is doing billing and coding she doesnt have her cpt certification
 
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Certain jobs require you to have a coding certification but if you're doing the billing in a small practice it's generally not required.
 

mitchellde

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I have a question is it a "law" in Michigan that you have to be a certified CPT coder? there is a girl in the office I work that is a medical assistant and she is doing billing and coding she doesnt have her cpt certification
Irritating isn't it! No as far I know this is not yet a law in Michigan, it is a law in a couple of states, and on a national level it is something they have discussed should be implemented, but so far no date on when this would be. The other response is correct in that you will find certain workplaces have a policy that only certified persons will preform the job, and others are more lax. I think everytime they have a non certified coder performing coding duties, and they then call themselves a coder, it takes away some of the professionalism we keep trying to establish.
 
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