medicare claim

when billing an office visit (99215) and a breast and pelvic exam (G0101) do you need a modifier?

nope

you do not for Medicare

Medicare claim

I would be very careful billing a 99215 and a G0101. You are billing a high level visit and a pelvic/breast screening. If I were Medicare, I'd ask to see the claim. I would be wondering, "Is this really a high level visit, or is it a physical exam (non-covered) in disguise.

I am not sure

I can see a 75 yr old diabetic, hypertensive, hyperlipidiemic patient with leg pain and chest pain warranting a 99215, but I probably would not throw her up in stirrups for her pelvic at that visit.

99215 and G0101

That's a good point: if the patient is that sick, are you going to do a pelvic exam that day?

I'm sure you never "throw" your patients anywhere!