Forum - Questions & Answers

Sep 18th, 2013 - TerryC 39 

G0101/Q0091 help

I need some clarification on G0101 and Q0091. Can this be billed to all insurances or is it just to be used for Medicare pts? If a patient just comes in for a pap we use the G0101 our new billing service said we should be just using the Q0091.Which is my understanding is only for the "obtaining,preparing" of the pap not the actual pap itself which I believe would be G0101. Can we use both of the codes together? and can they be used on insurances other than Medicare? Also our OBGYN doctors are using the 9939x codes for well woman exams. But than they see their primary doctor for their physicals and charge they charge a 9939x code. Should the OBGYN's just be using G0101 if only a pap is done and a E/M code if there is another dx to go with it? Sorry such a long question I hope to get some feedback

Sep 18th, 2013 - nmaguire   2,606 

re: G0101/Q0091 help

G0101: Medicare
http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/Screening-Pelvic-Examinations.pdf

Query each private payor for coverage (or not) details.

The G0101 has specific criteria required for billing, see link above.



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