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Medicare Pelvic Exam G0101 and Time Base coding

  1. Default Medicare Pelvic Exam G0101 and Time Base coding
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    Is it appropriate to bill Medicare- pelvic exam (G0101) and pap (Q0091) and /E/M 99212-25 based on time?

    The E/M 99212 was billed because the physician spent 15 min counseling and evaluating bone density results.
    Please advise??
    Or does anyone know of any Medicare reference where I can research?

  2. #2
    According to PGBA, you can only bill an E/M with the G0101 and Q0091 if is a separately identifiable service, which reviewing bone density results would qualify. You would use the -25 modifier (or they won't pay), with the diagnosis being the reason for the bone density. If your physician documents time spent, then you would use the E/M code that states "typically xxxx minutes spent w/ pt."

  3. Default
    Does anyone else have any thoughts on this?
    Thank you

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