Gyn exam

We are ob/gyn practice. We see Medicare patients for their annual exams without the pap smear. What is the best way to code this to get paid.

GYN exam

I think you'll find some articles of interest in the encyclopedia section of Codapedia:

http://www.codapedia.com/~article_358_.cfm

http://www.codapedia.com/~article_351_.cfm

http://www.codapedia.com/~article_112_.cfm

http://www.codapedia.com/~article_63_.cfm

If these don't answer your specific question, let us know.

Gyn

Medicare covers Pap Tests and Pelvic Exams (and a clinical breast exam) for all women once every 24 months. If the patient is high risk for cervical or vaginal cancer, or if they are of childbearing age and have had an abnormal Pap Test, Medicare covers this test and exam once every 12 months. If you have your Pap Test, Pelvic Exam, and Clinical Breast Exam on the same visit the patient has a physical exam, they pay for the physical exam. Routine physical exams are not covered by Medicare.
Report breast/pelvic exams with G0101
Examination of the breast is required when billing code G0101
Performance and documentation of any 7 of the following 11 elements
• Inspection and palpation of the breasts for lumps, tenderness, symmetry or nipple discharge
• Digital rectal exam
Pelvic exam including:
• External genitalia
• Urethral meatus
• Bladder
• Urethra
• Vagina
• Cervix
• Uterus
• Adnexa/parametria
• Anus and perineum

Don't forget the ABN

So when you patients come every year, they should get an ABN and told that they must pay for their exam as Medicare covers it every 2 years.

Gyn exam

I bill for a GYN. What I do is charge for the G0101, Q0091 and the exam however I reduce the exam by the amount on the G0101 and the Q0091. So if the total exam is listed as 355.00 I would break it down. It would then be 200.00 for the exam, 100.00 for the G0101 and 55.00 for the Q0091. I would bill it as Exam with V72.31, G0101 and Q0091 with V76.2 and any high risk diags that pertain. Medicare usually pays bot the G0101 and the Q0091.