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Wiki Ob/Gyn visit

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aschaeve

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Fond Du Lac, WI
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If a patient is seen by their primary care and that physicians bills a prevent. Now the patient presents to OB/BYN for the pelvic exam and pap. What should the OB/GYN bill?
 
Assuming the ob/gyn performed not just a "pelvic exam" but an actual annual well woman exam (of which the pelvic exam is a part), the ob/gyn should also bill a 99381-99397, but with the appropriate well woman annual exam diagnosis Z01.411 or Z01.419. Most insurances will not have any issue with this. Occasionally you may need to write a letter explaining. And Q0091 for PAP. For Medicare, look at G0101.
 
I suggest you look at G0101, but most private carriers don't recognize this as it is a Medicare code.
Or if the provider addressed any medical issues, then E/M 99201-99215.
As it stands, it looks like the provider did PART of an annual well woman exam.
 
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