Wiki Q0091 pap code HELP!

[knudsen.lisa]

When is it appropriate to bill the Q0091 code? I've been receiving conflicting information and I was hoping someone could help me clear things up.

My understanding is …

You can bill the Q0091 with the appropriate preventative service code. [Routine preventative annual service]

Example: 25 year old, New patient presents to clinic for routine annual services with collection of pap. 99385, Q0091

*However, If patient is on her cycle at annual visit and only receives preventative service (99385) but reschedules her collection of pap (Q0091) to a later date, we CAN bill out the Q0091 at her follow up pap visit. My understanding is, as long as the Q0091 was not previously billed at annual service (pap not preformed) we can bill it out at a follow up visit and insurance companies will pay for collection of pap. Is my thought process correct? Is there another more appropriate way to bill for her follow up pap? Please help!


My understanding for repeat and/or unsatisfactory paps is…

Unsatisfactory paps and or repeat paps can be billed as well using the appropriate E/M code and medical diagnosis code.
Example: 99213, 795.04 (Abn. Pap smear, HGSIL)

I would appreciate any feedback ! !


Thank you-

-Lisa Knudsen, CPC-A

 

[cedwards]

The code Q0091 is assigned only for Medicare patients. It is not assigned for a non-Medicare patient. Code Q0091 can be coded in addition to the preventive medicine code for a Medicare patient for a well-woman exam and the charges need to be carved out.

For a non-Medicare patient, collection of a screening pap smear is included in the preventive medicine code (Not coded separately).