Wiki Pap smear and physical exam

[umhamza123@hotmail.com]

Hi,
I am new at my job and I have a guestion about coding and billing pap when it is done with a preventive service:
can a pap (Q0091) be coded and billed with a regular physical? example: (99395-25, 36415, 99000, Q0091)? and will insurance pay for the pap or it is part of the physical? and what happens when a patient comes in for physicals and decides she wants to do the pap another day, do we collect the copay for an office visit when she comes next time for the pap or not, Example: (99212-25, Q0091) and what ICD-10 code should we use for the office visit when she comes the next time for pap?
Thanks

 

[MKESSINGER]

Pap and handling fee are part of the preventative exam unless she is a Medicare patient. Medicare you would have to carve out the exam. Example is you normally charge $170.00 for established patient 65 years or older then your charge could look like this:

99397-$70.00
G0101-$50.00
Q0091-$50.00

It has to add up to the same dollar amount if you were charging a preventative exam for a commercial patient. Also if she is a Medicare patient you have to present her with an ABN form to review and sign, use the appropriate modifiers and attache them to the procedure codes (GY,GZ, GX GA). If you don't then your office will not get paid.

Diagnosis codes are Z01.419 if normal findings during exam or Z01.411 is abnormal findings were found during exam.