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Medicare Pap and Pelvic Exam

  1. #1
    Default Medicare Pap and Pelvic Exam
    Exam Training Packages
    When billing Medicare for pelvic, pap, and breast exam can you use both
    Q0091 and G0101. We would not just perform the pelvic but a pap also along with the breast exam. What are your thoughts on this?
    Thank you,
    Andi
    Andi M.
    CPC

  2. #2
    Default pap and pelvic
    Quote Originally Posted by andi View Post
    When billing Medicare for pelvic, pap, and breast exam can you use both
    Q0091 and G0101. We would not just perform the pelvic but a pap also along with the breast exam. What are your thoughts on this?
    Thank you,
    Andi
    We do it both ways, there are times we do the pelvic/breast and defer the pap so you would just use one code, then there are times we do them both so you would use both G and Q codes. Depends on the situation.

  3. #3
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    We are getting denied on the G code from Medicare. Andi
    Andi M.
    CPC

  4. #4
    Default
    Hopefully this will help you.....Go see http://www.cms.hhs.gov/MLNProducts/d...nceChart_1.pdf

    Here in our clinic it is understood if they want an annual pap and breast exam is done, it is also understood from my doctors if a pap is done the pelvic is done. You can't bill the breast exam without the pelvic--G0101( these are covered every 24mths) with the screening codes, Talk to your doc! Medicare has a lot of useful info, enter G0101 in the search engine on Medicare website...

    Hope this help! Good Luck

  5. Default
    we also bill the GO101 using v76.49 if it is a low risk patient and Q0091 with v76.2, we don't have any problems as long as it is medicare's year to pay. We only run into problems trying to convince the patient that it is in they booklet from Medicare that this is only covered every 24 months.

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