Results 1 to 5 of 5

Screening Pelvic and Breast Exam

  1. Default Screening Pelvic and Breast Exam
    Medical Coding Books
    On a Medicare screening pelvic and breast exam (G0101), is it a requirement to perform the breast exam or can the exam include at least 7 of the 11 elements without examination of the breast? Thank you!

  2. #2
    CMS states that a breast exam is no longer required in order to report G0101, however you still must perform at least 7 of the required 11 elements below in order to report G0101:

    • Inspection and palpation of breasts for masses or lumps, tenderness, symmetry or nipple discharge

    • Digital rectal examination including sphincter tone, presence of hemorrhoids, and rectal masses

    • External genitalia (for example, general appearance, hair distribution or lesions)

    • Urethral meatus (such as size, location, lesions, or prolapse)

    • Urethra (for instance, masses, tenderness or scarring)

    • Bladder (for example, fullness, masses or tenderness)

    • Vagina (e.g., general appearance, estrogen effect, discharge, lesions, pelvic support, cystocele or rectocele)

    • Cervix (for example, general appearance, lesions or discharge)

    • Uterus (such as size, contour, position, mobility, tenderness, consistency, descent or support)

    • Adnexa/parametria (for instance, masses, tenderness, organomegaly or nodularity)

    • Anus and perineum.
    adrianne, cpc

  3. Default
    Thank you for the response! This has been my understanding also, however, our auditor pointed out in the the Guide to Medicare Preventive Services July 2009 the following statement: 'the pelvic examination includes a clinical breast examination, which aids in helping to detect and find breast cancer or other abnormalties.' Any ideas?? Thanks!

  4. #4
    Ask for them to specify what they mean by that and show them CMS' statements.
    adrianne, cpc

  5. #5
    Default Screening Pelvic and Breast Exam
    We are being instructed that the breast exam is a required element, but I'm curious to see how others feel. I still feel it isn't required and is optional to be one of the 7 of 11 elements.

Similar Threads

  1. Screening pelvic exam
    By MACACERES in forum Medical Coding General Discussion
    Replies: 2
    Last Post: 08-13-2015, 10:41 AM
  2. Screening pelvic exam
    By Lynda Wetter in forum Medicare Regulations
    Replies: 1
    Last Post: 06-25-2013, 06:22 AM
  3. Replies: 8
    Last Post: 12-09-2011, 02:30 PM
  4. Screening Pelvic Exam
    By j.berkshire in forum OB/GYN
    Replies: 5
    Last Post: 06-18-2009, 11:41 AM
  5. pelvic breast exam
    By scharette in forum OB/GYN
    Replies: 1
    Last Post: 11-07-2007, 12:43 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.