Wiki Medicare preventative visit

[oaf91590]

My doctor wants G0101,GA billed with Q0091,GA and no E/M codes. The ICD-9 is V76.2, the patient is 69yo and hasn?t had a PAP/screening in the past 2 years. We have had a lot of problems with this. Why would G0101 get paid and NOT Q0091?

 

[mitchellde]

Has your patient had a hysterectomy?

 

[Amy Pritchett]

I would check the chart to make sure the patient has not had a hysterectomy. In this case, Medicare will only pay for the G0101-GA with the V76.2 as the diagnosis code.

Hope this helps!

 

[mitchellde]

If the patient has has a total hyst you would not use the V76.2 at all as there is no cervix to PAP, if a PAP was performed it would be a vaginal PAP.. V76.47. The well woman is coded as V72.31 and includes the V76.2, but you must add the V76.47 and the Vcode for the absence of uterus and cervix.

 

[oaf91590]

No hysterectomy

The patient has had a tubal ligation but no partial or total removal of uterus. Thank you for your responses!

 

[mitchellde]

Then use the V72.31 as the code.