# Q0091 question?????



## annej0 (Mar 23, 2011)

I have MCR patient (69yrs old) that was seen in the office for post menopausal bleeding and the doctor billed a 99214 and Q0091 with a diagnosis of 627.1.  Is this correct?  

(part of dictation below)
HPI: Noticed vaginal bleeding since this AM more than menses. Has sharp pain in low abd for a long time. Vaginal irritation for 2mos with d/c

Review of Systems 
General: Patient complains of see HPI, malaise.  Patient denies weight loss.  
Breast: Patient denies masses, nipple discharge.  
Gastrointestinal: Patient complains of see HPI, abdominal pain.  Patient denies change in bowel habits, melena, hematochezia.  
Genitourinary: Patient complains of see HPI, vaginal discharge, abnormal vaginal bleeding, pelvic pain.  Patient denies dysuria, hematuria.  
Musculoskeletal: Patient denies back pain.  

Impression & Plan Summary: 
POSTMENOPAUSAL BLEEDING. 
-pap done

Any help I can get on this will be greatly appreciated!


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## coding303 (Mar 23, 2011)

The Q0091 is just for obtainin the pap and is covered once every two years.  You can also use the G0101 for cancer screening.


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## bonzaibex (Mar 28, 2011)

Q0091 is for the billing of a screening pap smear.  These are the dx codes covered for Medicare patients:  V76.2, V76.47, V76.49, V15.89, V72.31.  It is covered annually for high-risk patients and those of child-bearing age with an abnormal pap within the last 3 years.  It is covered every 24 months for everyone else.  

Becky, CPC


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## mitchellde (Mar 28, 2011)

Your documentation does not support a screening pap so the pap is simply part of the E&M.


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## annej0 (Mar 28, 2011)

I was thinking that is was part of the E/M but have one dr. that wants to use it all the time for diagnostic.  Thanks for the help.


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## MJ4ever (Mar 31, 2011)

The pap is included in the E&M because it is not a screening.


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