Q0091

sandyt

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I have just started working for a Family Practice Center and have no experience with OB/GYN. I am being told that the docs believe many private insurances pay for the Medicare code Q0091 but all the research I've done leads me to believe this isn't true. The docs suggest that we use the code anyway just in case. Can someone please tell me the facts about this. I am not used to throwing random codes on claims just in case they might pay. It has been my experience that this leads to more denials than it does reimbursements. Help please!:eek:
 

zanalee

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We use it at work, but if patient came in for a well woman visit is included in the EM which you do not need to add the G code. if you have a separate unrelated problem append modifier 25 to the EM level..
 

sandyt

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Thanks for responding but I'm still not clear. These are well woman visits billed to private payors DX-V72.31 PX-993--however old they are. Should I add the Q0091 to this as well?:confused:
 
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Are you billing out S0612/G0101??
You can bill Q0091 with these codes.

If billing w/ OV (99214-99215) and mod 25 to ov & add mod 59 to Q0091

:)

Hope this helps
 
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