# G0101 - I was wondering if anyone has the link



## kbarron (Sep 14, 2009)

I was wondering if anyone has the link to the requirements that are to be met to use this code? Thanks in advance.


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## jgf-CPC (Sep 14, 2009)

*G0101*

Try this and hope it helps!!!!

http://www.acog.org/departments/coding/MedicareScreeningServices.pdf


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## kbarron (Sep 14, 2009)

This is exactly what I was looking for and then some.


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## Brenda Koldys (Sep 14, 2009)

Here is a link that might be helpful.  

Also here is what I use as guidelines:

Medicare covers a screening breast and pelvic exam once every two years. In order for this service to be paid the provider's exam must include at least seven elements, which are shown below.

G0101=669202 Breast and pelvic exam

	Q0091=99004 is Obtaining, preparing and conveyance of the cervical or vaginal smear to the lab

Diagnosis Codes:
V76.2-Cervix (routine Cervical Pap smear)
V76.47-Special screening for malignant neoplasm, vagina
V76.49-Special screening for malignant neoplasm, other sites
		V76.49- for a patient without a uterus or cervix
V15.89- high risk-indications listed below
for cervical cancer: early onset of sexual activity (under 16 years);
multiple sex partners (5 or more per lifetime); history of STD; fewer than 3 negative Pap smears within the previous 7 years
for vaginal cancer: exposed daughters of women who took DES during  pregnancy

Required Documentation
In order for the screening breast and pelvic examination to be covered by MEDICARE, the provider's exam must include at least seven (7) of the following eleven (11) elements:
1. Inspection and palpation of breasts for masses or lumps, tenderness, symmetry, or nipple discharge
2. Digital rectal exam including sphincter tone, presence of hemorrhoids, and rectal masses
Pelvic exam (with or w/o specimen collection for smears and cultures) including:
3. External genitalia (e.g., general appearance, hair distribution, or lesions)
4. Urethral meatus (e.g., size, location, lesions, or prolapse)
5. Urethra (e.g., masses, tenderness, or scarring)
6. Bladder (e.g., fullness, masses, or tenderness)
7. Vagina (e.g., general appearance, estrogen effect, discharge, lesions, pelvic support, cystocele, or rectocele)
8. Cervix (e.g., general appearance, lesions, or discharge)
9. Uterus (e.g., size, contour, position, mobility, tenderness, consistency, descent, or support)
10. Adnexa/parametria (e.g., masses, tenderness, organomegaly, or nodularity) 
11. Anus and perineum


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