Pelvic exam not with yearly Well Woman physical

If a patient comes in to be seen for a possible STD or unusual vaginal bleeding or some situation in which the provider does a pelvic exam; how would I bill that? It is not a yearly physical of preventive. Would I use a EX: 99214 with V72.31, as that is with or without a Pap; and add any other DX like post menopausal bleeding?

re: Pelvic exam not with yearly Well Woman physical

V72.31 is only for routine gynecological examination which is associated with Well Woman exams. If the patient is being seen for unusual vagianl bleeding you should be coding for that diagnosis or the DX that the provider provided.

re: Pelvic exam not with yearly Well Woman physical

No separate code for diagnostic pelvic exam exists. This service would be incorporated into an Evaluation and Management code (9920x-9921x). The diagnosis code would either be the actual problem or, if no diagnosis has been established, the signs and symptoms.