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Papsmear billed with E&M or H&P

  1. #1
    Location
    St. Cloud, MN
    Posts
    58
    Red face Papsmear billed with E&M or H&P
    Medical Coding Books
    We are having a problem with getting reimbursed for our papsmear and pelvic exams Q0091 and G0101 when being billed with a problematic E&M or with an H&P code. BCBS states that they are inclusive and we do not know what to do. I am hoping for help on this one.

  2. #2
    Location
    Seacoast- Dover New Hampshire
    Posts
    609
    Default
    It is my understanding that the Q0091 and G0101 are for Medicare only. With BX I wonder if you are billing the the correct Preventative visit code. Pap is considered included with the Preventative codes. Any other comments?
    Karen Barron, CPC
    Hampton New Hampshire Chapter

  3. #3
    Location
    Greeley, Colorado
    Posts
    2,045
    Default
    I agree with Karen. I have never used Q0091 or G0101 for anything but Medicare.
    Lisa Bledsoe, CPC, CPMA

  4. #4
    Default
    I have used Q0091 but never G0101 for other insurances. Most insurances do pay for Q0091 from my experience!
    Herbie W Lorona Jr., CPC, CPC-H
    hlorona@up2parmedicalclinic.com

  5. #5
    Default
    If it is a Blue cross/blue shield pt, we normally use code S0610 or S0612 for paps. I am not sure if this helps.

  6. #6
    Location
    St. Cloud, MN
    Posts
    58
    Smile Papsmear
    Thanks for all your advice. I am glad to be getting into this field of everchanging information. I love a challenge and appreciate all your help. It really has helped me greatly.

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