Wiki Well Women Exams

[Lisa Bledsoe]

I have researched most of our insurance carriers in our area and have found that they DO recognize and reimburse for Q0091 and G0101. Given that information, wouldn't it be appropriate to code as we do with Medicare and not only report the preventive code but also Q0091 and G0101? If so, should the fees be carved out as we do for Medicare?
TIA!!

 

[imjsanderson]

I believe they recognize this as a secondary payer. We use the preventative code and the Q0091 if a pap was done. Not all payers will reimburse the
Q0091 with the preventative but some do. Most will say it is included in the preventative portion. Also, the Q0091 can only be billed if you are sending the specimen to an outside lab.

 

[friley]

If you are reporting the Preventive Services CPT codes, then Q0091 and G0101 are generally considered a component of/or included in the preventive visit by commerical payors. If only performing the well female preventive exam and not a complete preventive service as described by the CPT code, then report Q0091 and or G0101. CMS uses the HCPCS codes to monitor and limit the intervals between payment for these services.

 

[Lisa Bledsoe]

Thanks to both of you.