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Thread: Medicare Well-Woman Exams

  1. #1

    Question Medicare Well-Woman Exams

    AAPC: Back to School
    Can someone tell me how they bill for Medicare well-woman exams??? I know that Medicare does not pay for the cpt codes 99381-99397 with the V72.31 dx code, and the patient signs the ABN form. I am having trouble getting the G0101 codes and the Q0091 codes paid for with the V72.31. If I could get some advice and help coding this, I would really appreciate it.
    Thank you.
    Physicians Billing

  2. #2
    Join Date
    Apr 2007
    Seacoast- Dover New Hampshire

    Default medicare exam

    I would use V15.89 or V76.2 depending on the circumstance. You may carve out the 99397. Good Luck
    Karen Barron, CPC
    Hampton New Hampshire Chapter

  3. #3
    Join Date
    Apr 2007
    Greeley, Colorado


    Try this link for some information: http://www.cms.hhs.gov/MLNProducts/d...nceChart_1.pdf

    Make sure your patients are not having these services too frequently per Medicare.

    As mentioned above, these services are carved out of your fee for 99397 so that the patient is not charged the full fee for 99397 on top of the G/Q codes.
    Lisa Bledsoe, CPC, CPMA

  4. #4
    Join Date
    Apr 2007

    Default Medicare Well Woman exams

    Try visiting this link http://www.capturebilling.com/medica...m-g0101-q0091/

    I Bill the G0439 with G0101 and Q009 This website tells you what DX codes to use for each one.

  5. #5
    Join Date
    Apr 2007
    Columbia, MO


    A well woman exam for Medicare is a V72.31 with the G0101 and Q0091, Medicare covers this every other year, If you timing is off by one day then Medicare can and will deny the service as non covered. Also if the patient has had a total hysterectomy you must add the V76.47 with the appropriate V88.x code. If the patient had a hyst with a remaining cervical stump then you need to add just the V88.x.

    Debra A. Mitchell, MSPH, CPC-H

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