Working for a gyn office, patient has medicare, patient came in for annual well woman exam and lichen follow up. Dr coded the exam 99213,25 and 99397,GX G0101,GA, is this correct? For annual well-woman exams at a specialist GYN office how do you bill. I am aware of the carve out rule. Want to bill correctly.
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Wiki medicare coding
- Thread starter nikkigrimjordan@aol.com
- Start date
nielynco
True Blue
Technically yes, but I would question as to whether the pelvic exam was performed as a screening under Medicare guidelines that she is eligible for in the covered year, or was done to exam her for the follow-up due to the lichens. If done for lichens, you should not be also counting the exam towards Medicare requirements or vice-versa.
Thank you for your response, in addition, if a patient comes in for just an annual well woman exam and it is their year medicare will cover the g0101 do you bill just the g0101 or 99397
nielynco
True Blue
If it is a covered year you bill G0101 for the Medicare portion. If the provider did more than this you would bill the patient (or her secondary insurance) for 99397.