For the patient's who want their gynecological services performed by the female provider in the office, is there a reason why they are then scheduled with the male provider?
In my honest opinion, I would be very unhappy with my doctor's office if I only wanted my gynecological services performed by the female provider in the office but they wanted to schedule my full preventive with the male doctor.
This being the case of what actually happened, does not take away from the fact that there are two separate dates of service and two separate services being performed. It is imperative to check with the patient's carrier. Each carrier has differing policies on how often preventive services may be billed and how they may be billed.
For example, in Michigan, BCBS of Michigan requests separately provided gynecological services be billed with S0610 or S0612, or G0101 if the patient is high risk, and Q0091 if there was a pap smear collection taken. These codes would be billed if the gynecological services were provided on a separate date of service from a preventive maintenance examination, whether the same provider or different.
Also, Medicare allows preventive maintenance examinations and gynecological services billed on the same date of service. In addition, if a separately identifiable E/M is performed that is also billable.
Another carrier, SPHN, allows multiple preventive E/M's (9938X - 9939X) billed throughout the calendar year. SPHN indicates they expect the
diagnosis code to advise what was done, e.g., V70.00 for the routine preventive and/or V72.31 (example only) for the gynecological services for a patient who has not had a hysterectomy.
In my honest opinion, I would not just include this service in the original preventive examination. It is possible to lose out on completely appropriate reimbursement by doing that.
Hope this helps.
Kris