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Well woman exam / deferred Pap due to Menses

  1. #1
    Default Well woman exam / deferred Pap due to Menses
    Medical Coding Books
    Hi All;

    I know there is written guidance out here and I'm having a bit of trouble finding it.

    SCENARIO: When a patient comes in for her well woman exam, (specifically, Preventive Exam CPT 99381-99397) and she is on her monthly period; the physician defers the pap until one week later.

    My understanding is that the diagnostic pap is included in the preventive exam as that is our "age and gender appropriate ...exam... and the ordering of lab / diagnostic procedures..." (AMA's CPT 2009 E/M Preventive Med Svcs 99381 / 99391 descriptors)

    I would not code the return visit as a separate E/M when it is strictly to FINISH the Preventive exam.

    How would you code the return visit? Is there any written guidance that you can refer me to?

    Thank you.

    Susan R.; CPC, CEMC

  2. Default
    Preventive exams may include pap smears, too.
    But if postponed to another visit, can submit with Q0091-V72.31 along with or even without an E/M as required.
    But kindly enquire the payor if they pay for Q codes.
    I think UHC, BCBS, Promed, insurances pay for Q codes.


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