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Wiki S0612 vs S0613

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rthames052006

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Hello-

I've read through quite a few posts on OB forum and have a question that I am hoping someone could answer for me.

Wtih everything I've read I understand that S0612 is when a pelvic exam and pap are obtained and I've seen the final rule and the CMS guidelines that state a screening pelvic exam should include at least 7 of the 11 elements. My question is if the provider does a "manual exam" and breast exam would this be the instance where you'd use the S0613 since the provider isn't hitting the 7 of the 11 elements and no pap is done?

I have a few providers who are following the advice that a pap does not need done every year so they are only doing "Well Woman Exams". I just want to be certain that I am understanding correctly what they are doing. And my better judgement is telling me they are doing a well woman S0613 when they say they are doing a manual exam and the exam of the GU consists of:

isnpection and palpation of breasts
external genitalia
urethral meatus
anus and perineum

I am not a member of the ACOG so I can't even get on their site to see what information they may have related to this topic.

I just want a better understanding, if anyone can assist me.

Thanks,
 
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