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Cpx/breast Exam Help!

  1. #11
    Medical Coding Books
    I agree with Alaina, that is how we bill those scenerios too.

  2. #12
    Greeley, Colorado
    Quote Originally Posted by debi2205 View Post
    So when a pt comes in for Just for her Well Women exam (not Medicare) are you using 9921X and V72.31, V76.2 or G0101 and Q0091 and how are being reimbursed? We have this controversy because we will do the CPE 9938X and pt may go to another one of our docs for her Pap then what??
    I am finding most ins will only pay for 1 preventive CPT code per 365 days and if we break it down in 2 visits they have exceeded their limit.??????
    True - most insurance carriers will only pay one per year regardless of V70.0 and V72.31. Also, as far as I know, only Medicare recognizes the G and Q codes...
    Lisa Bledsoe, CPC, CPMA

  3. Default
    Alaina is %100 correct. That is how we do it in our family practice. We have pt that come in for cpx/pap but we find out they are on period, then we only do cpx with prevenative and dx V70.0. Then they come back on a different date for pap only and we do office level only and use dx V76.2 pap only.

    Hope this helped


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