Forum - Questions & Answers

Oct 30th, 2009 - j.berkshire 7 

Screening Pelvic With Surgical Absence

Medicare requires the exam of 7 of the 11 elements from the female GU exam template to bill the screening pelvic, G0101. If two of the 7 elements are surgically absent (i.e. due to past history of hysterectomy) do you still bill for the G0101? Please provide a reference or citation if available. Thanks.

Jenny Berkshire, CPC, CEMC, CGIC

Oct 30th, 2009 - Codapedia Editor 1,399 

G0101 with surgical absence

The breast exam is required, of course.

Then, even after a hysterectomy, you need 6 more elements. The citations are located in the article titled G0101 pelvic and breast exam.

You can get them, but the doctor has to document things that they typically don't.

Examination of the breast is mandatory to bill G0101
• Inspection and palpation of the breasts for lumps, tenderness, symmetry or nipple discharge (ONE)
• Digital rectal exam (TWO)
Pelvic exam including:
• External genitalia (THREE)
• Urethral meatus (FOUR)
• Bladder (FIVE)
• Urethra (SIX)
• Vagina (MAYBE EIGHT)
• Cervix
• Uterus
• Adnexa/parametria
• Anus and perineum (SEVEN)



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