S CODES

bevlewis07

Networker
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Phoenix, AZ
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Hello All

I hate to say it out loud but is anyone using the S0610, S0613, S0612 codes for commercial plans??

Back story:
I had a patient come in for her breast and pelvic exam, in which I coded out my usual 99 preventive code but I used the Z code for STD screening as primary... my claim was paid in full but I have been contacted by the patients insurance and the patient stating that I am to use another CPT code so that her PCP can be payed for his preventive exam.

I stumbled on those "S" codes and I can not fix myself to use them because that has never been my way of billing.

My question is, do you think the reason the insurance company will not pay both claims is because I failed to use the Z01.419 gyn dx code as primary ?? Has anyone else had this happen to them?? is the S codes appropriate for Gynecology offices?? :eek::cry:
 

CodingKing

True Blue
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You would not use S codes unless the specific payer requests them. See if you can bill G0101 Cervical or vaginal cancer screening; pelvic and clinical breast examination
 
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