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Wiki medicare preventive exam

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LindseyR

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Richmond, Virginia
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Hello all, can someone tell me the correct way to bill preventive exams for medicare patients effective 2011....there are new G codes to use I believe...

G0438 and G0439

so ..when an established medicare patient comes to our obgyn office for their annual exam/pap am I billing
G0439-ANNUAL
G0101-PELVIC BREAST
Q0091-SPECIMEN
G0328-HEMOCCULT SCREENING
???

I am a tad confused......
 
Medicare Annuals

Good afternoon Lisa,

We have also been confused about billing the new Medicare Annual codes as we are an OB/GYN office not a PCP. Can you please send me a copy of your worksheet as I have tried to look on multiple websites to find the correct information and have come up with nothing.

Thanks so much! :)

Amber Ruiz, CPC
Women's Health Today
aruiz@whtmd.com
 
Medicare preventive exam

Lisa, I would like a copy also.


Our office is a PCP and we are billing as follows:

First preventive exam: code G0438 because this is the first time the patient has it since it is allowed, even if this is a established patient.
Next year, we will use the code G0439 for the same patient and consecutively the next years.

If it is a physical exam, we are using V70.0
if it is a gyn exam , we use V72.31
and we add to Q0091 pap smear, code V72.32

My question is : is it allowed to bill both codes G0101 and G0438/9?
 
This is from the medicare transmittal on AWV:
These services do not replace the Pap (Q0091) or Pelvic and Breast exam (G0101) that Medicare covers every 2 years (yearly for high risk patients). The AWV codes G0438 and/or G0439 can be reported with Q0091 and G0101 for female patients. G0102 (prostate screening DRE) is also reportable with G0438 and/or G0439 for male patients (yearly).
 
Annual visits article

Can I please get a copy of that article as well?

I'm in gyn/onc and we don't do very many annuals visits since our patients come more than every 2 yrs., but there are a select few that will have an annual when in remission.

Thank you.
Please send to my email at akonyk@gmail.com
 
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