# Screening Pelvic Exam



## j.berkshire (Jun 18, 2009)

I'm auditing a note in which the physician documents the exam of 5 elements of the screening criteria for screening pelvic exam.  Since 7 are required to bill G0101, would anyone suggest billing G0101-52?  Is there another option for billing this physician service?


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## kbarron (Jun 18, 2009)

Did he examine the breast also?


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## amjordan (Jun 18, 2009)

Modifier -52 is not a valid modifier for G0101.  If 7 of the 11 elements aren't documented, then you don't have a billable service based on the G0101 guidelines.


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## j.berkshire (Jun 18, 2009)

No, he did not examine the breasts.  Why isn't 52 modifier appropriate?  Is that anywhere in the regs?  I couldn't find anything in the Medicare Carriers' Manual.  I hate to see physicians provide services and not be able to bill for them.


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## amjordan (Jun 18, 2009)

I might have spoken to soon.  My carrier is WPS and they do not allow -52 on any E/M service and G0101 is considered the covered portion of a preventive E/M service.  Now, your carrier may be different.


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## j.berkshire (Jun 18, 2009)

You're right, Angela.  My carrier, Palmetto, indicates the 52 modifier cannot be used for E&M services.  Thanks for the insight.  (I still hate to give up on billing a physician service.)


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