Wiki Q0091 question?????

[annej0]

I have MCR patient (69yrs old) that was seen in the office for post menopausal bleeding and the doctor billed a 99214 and Q0091 with a diagnosis of 627.1. Is this correct?

(part of dictation below)
HPI: Noticed vaginal bleeding since this AM more than menses. Has sharp pain in low abd for a long time. Vaginal irritation for 2mos with d/c

Review of Systems
General: Patient complains of see HPI, malaise. Patient denies weight loss.
Breast: Patient denies masses, nipple discharge.
Gastrointestinal: Patient complains of see HPI, abdominal pain. Patient denies change in bowel habits, melena, hematochezia.
Genitourinary: Patient complains of see HPI, vaginal discharge, abnormal vaginal bleeding, pelvic pain. Patient denies dysuria, hematuria.
Musculoskeletal: Patient denies back pain.

Impression & Plan Summary:
POSTMENOPAUSAL BLEEDING.
-pap done

Any help I can get on this will be greatly appreciated!

 

[coding303]

The Q0091 is just for obtainin the pap and is covered once every two years. You can also use the G0101 for cancer screening.

 

[bonzaibex]

Q0091 is for the billing of a screening pap smear. These are the dx codes covered for Medicare patients: V76.2, V76.47, V76.49, V15.89, V72.31. It is covered annually for high-risk patients and those of child-bearing age with an abnormal pap within the last 3 years. It is covered every 24 months for everyone else.

Becky, CPC

 

[mitchellde]

Your documentation does not support a screening pap so the pap is simply part of the E&M.

 

[annej0]

I was thinking that is was part of the E/M but have one dr. that wants to use it all the time for diagnostic. Thanks for the help.

 

[MJ4ever]

The pap is included in the E&M because it is not a screening.