Wiki Pap and Pelvic exama

[tracyll]

I work for a family physician and have been billing pap and pelvic exams as a 99214. Is there another code that should be used other than a preventive medicine code?

 

[mitchellde]

If these are a well woman exam then you should use the prevent visit codes. If the pap and pelvic are part of a symptomatic visit then it is part of the visit level.

 

[tracyll]

I wasn't sure if we could use the preventive code with not being the patients PCP.

 

[mitchellde]

If you are performing a well woman then you use the V72.31 dx code with a prevent visit level. The V72.31 identifies this as a well woman.

 

[tracyll]

Thank you so much!!

 

[mitchellde]

I should have added that for Medicare a well woman is the G0101 and the Q0091 in lieu of the preventive visit level. You should be aware that some commercial carriers follow this policy as well.

 

[teresabug]

There are 3 other codes as well for Medicare that are considered the following:

G0402 Initial "welcome to Medicare" preventive (many "screenings" are payable one time; check out MLN Matters website and do a search using this G codes. Many providers are not aware that additional revenue is available at the same visit.)
G0438 Annual wellness visit
G0439 Subsequent annual wellness visit

 

[TMB1965]

Ok, so for a welcome to medicare patient it would either be:

G0101
Q0091

or

G0402
Q0091