How many ROS Do you need for Medicare

I need clarification on coding for Medicare patients. We are gynecology and our patients come yearly for breast and pelvic exam. Every other year we do a pap with the breast and pelvic exam. My doctor does ENT, eyes, Thyroid check, chest, breasts, kidney, liver, spleen, pelvic and if patient has problem then I code for it.

So is G0101 and if pap done Q0091 the only thing I can charge unless patient has a problem then should I code additional visit with modifier or charge a E/M 99214?


I called Medicare and they told to bill G0438 and G0439 then decided that we did not document for that so they asked for some money back.

HELP!!

Thank you

Karin

re: How many ROS Do you need for Medicare

Please see my original message below but I am so confused and need help so bad! My doctor does a full physical on medicare and if they are only here for breast and pelvic screening and he finds fibrocystic changes and they want refill on hormones for atrophic vaginitis. No pap. Can I charge G0101 and 99213-25 v72.3 and 627.3 and 610.1? Patient came on for breast pelvic screening and refill on meds. Who can I call I need to speak to someone and Medicare will not give me the correct answer!!
Please please please someone help me who is a certified coder!

Thank you

Karin Bowles
Conroe Ob-Gyn