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Woment wellness coding

J

johannabobyn@hotmail.com

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1
Location
Easton, PA
When patient is being seen by family medicine for a pap and E/M codes 99212-99215 utilize can add on code 99459 can be use . and if so will the practice get paid . This is with a comercial insurance.
 
I am assuming that the E&M code is being reported to manage a condition or disease, and that you're not reporting 99212-5 for a well-woman exam. Coverage for 99459 is really payer-specific. Some expect that the examination done in the E&M would bundle the pelvic exam, so they won't pay separately. You can also bill a Q0091 for the pap, (some payers will allow this), with a -25 modifier on the E&M.
 
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