Genital Prolapse

We have a patient who has a genital prolapse and the Dr wants to make sure that her insurance will pay for a pap smear....can anyone help me?

re: Genital Prolapse

If it is a preventive/screening, it should fall under the ACA mandate. Why does your Dr. think the insurance wouldn't cover it?

re: Genital Prolapse

she was concerned since it wasn't a full well woman exam I guess but was concerned of course of how serious it could be and the woman wanted to make sure her insurance would cover it and had already waited 3 months to come to the doctor because she "felt like her uterus was falling out"

re: Genital Prolapse

That sounds like it would fall under a non-WWE (problem) E&M coding the prolapse, so that might get dicey. Call the insurance and check her MD office "sick" benefit to see if it would be subject to a copay or deductible/coins. The Pap should be covered if the specimen is coded V76.2 (not the prolapse), and she has not had one elsewhere in the past year (or two years for Medicare).