You can bill Medicare for 99397 - it will just be denied as not a benefit and be the patient responsibility. Basically, what you need to do is code Q0091 for obtaining the pap, G0101 for breast and pelvic exam. You carve the fees for those codes out of the 99397 and only bill the patient the difference. You can find this information on your local carrier site, MedLearn Matters and CMS.
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