Wiki medicare v72.31

[pscott]

I have a question involving Medicare and the use of V72.31.
A patient saw the doc for Atrophic Vaginitis, and does a screening
with a pelvic exam, Q0091 and G0101. Payment was denied because
I didn't use V72.31, as it was really diagnostic, and not a screening.
what should I have used?
Thanks!

 

[kathy a]

Katherine Albert, CPC

I would use the V72.31 first and 627.3 second as the diagnosis codes.

 

[mitchellde]

I have a question involving Medicare and the use of V72.31.
A patient saw the doc for Atrophic Vaginitis, and does a screening
with a pelvic exam, Q0091 and G0101. Payment was denied because
I didn't use V72.31, as it was really diagnostic, and not a screening.
what should I have used?
Thanks!

If you are saying it was a diagnostic encounter and not a screening then you should not use the G0101 nor the Q0091, you may bill using an office visit level with the dx code for the problem. If you use the G and the Q code you are indicating a well woman exam which is why they want the V72.31. You cannot use the V72.31 nor the G and Q for a diagnostic encounter.

 

[kathy a]

If it was diagnostic then I would not have coded it as a screening-sorry. I would use an E and M code, and use the atrophic vaginitis as the dx code.