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Cpt code and hcpc together

  1. Default Cpt code and hcpc together
    Medical Coding Books
    WE HAD A PATIENT COME IN WITH MEDICARE WHO WAS NOT HERE FOR AN WELL WOMAN SHE WAS HERE FOR A PROBLEM VISIT.

    WE BILLED A 99213 WITH A Q0091 COLLECTION OF A PAP BECAUSE A PAP WAS DONE ON THIS DAY.

    IS THIS CORRECT CAN YOU BILL A Q CODE WITH A OFFICE VISIT CODE? WE HAVE SOMEONE IN OUR OFFICE THAT SAYS NO WE SHOULD NOT HAVE BILLED A Q CODE WITH A OFFICE LEVEL VISIT PLEASE LET ME KNOW YOUT OPINIONS. THANKS

  2. #2
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    North Carolina
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    3,126
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    Effective for services on or after April 1, 1999, a covered evaluation and management (E/M) visit and code Q0091 may be reported by the same physician for the same date of service if the E/M visit is for a separately identifiable service. In this case, the modifier “-25” must be reported with the E/M service and the medical records must clearly document the E/M reported. Both procedure codes should be shown as separate line items on the claim. These services can also be performed separately on separate office visits.

    Pg*89*

    http://www.cms.hhs.gov/manuals/downloads/clm104c18.pdf

  3. Default Hello Coding Associate
    In my personal opinion you should not code the QOO91 because in the code descriptor in your HCPCS book it states obtaining a specimen cervical or vaginal for a SCREENING pap. Since this person came in for a problem focused visit this would not be considered a screening. Obtaining the specimen is integral to the office visit for this day and should not be included in my opinion.
    Thanks
    Amanda L.

  4. #4
    Location
    Greeley, Colorado
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    2,045
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    See Rebecca's post - as an example:
    If the OV (E/M) and the pap were of a different nature - i.e. the patient came in for something like hyperlipidemia (E/M) and the provider saw that she was due for her pap (Q0091) then both are reportable. Absolutely you can code an E/M and Q0091. However if the patient came in for follow up to an abnormal pap, then Q0091 would not be appropriate, only an E/M would be reported.

    Perhaps we need a little more information about the encounter in question?
    Lisa Bledsoe, CPC, CPMA

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