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Thread: Q0091 question?????

  1. #1
    Join Date
    Apr 2007

    Question Q0091 question?????

    AAPC: Back to School
    I have MCR patient (69yrs old) that was seen in the office for post menopausal bleeding and the doctor billed a 99214 and Q0091 with a diagnosis of 627.1. Is this correct?

    (part of dictation below)
    HPI: Noticed vaginal bleeding since this AM more than menses. Has sharp pain in low abd for a long time. Vaginal irritation for 2mos with d/c

    Review of Systems
    General: Patient complains of see HPI, malaise. Patient denies weight loss.
    Breast: Patient denies masses, nipple discharge.
    Gastrointestinal: Patient complains of see HPI, abdominal pain. Patient denies change in bowel habits, melena, hematochezia.
    Genitourinary: Patient complains of see HPI, vaginal discharge, abnormal vaginal bleeding, pelvic pain. Patient denies dysuria, hematuria.
    Musculoskeletal: Patient denies back pain.

    Impression & Plan Summary:
    -pap done

    Any help I can get on this will be greatly appreciated!

  2. #2


    The Q0091 is just for obtainin the pap and is covered once every two years. You can also use the G0101 for cancer screening.

  3. #3
    Join Date
    Apr 2007
    Engelwood, CO


    Q0091 is for the billing of a screening pap smear. These are the dx codes covered for Medicare patients: V76.2, V76.47, V76.49, V15.89, V72.31. It is covered annually for high-risk patients and those of child-bearing age with an abnormal pap within the last 3 years. It is covered every 24 months for everyone else.

    Becky, CPC

  4. #4
    Join Date
    Apr 2007
    Columbia, MO


    Your documentation does not support a screening pap so the pap is simply part of the E&M.

    Debra A. Mitchell, MSPH, CPC-H

  5. #5
    Join Date
    Apr 2007


    I was thinking that is was part of the E/M but have one dr. that wants to use it all the time for diagnostic. Thanks for the help.

  6. #6
    Join Date
    Apr 2007
    Temple, TX


    The pap is included in the E&M because it is not a screening.
    The Oracle

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