# Screening Pelvic and Breast Exam



## tkeeton7885 (Nov 2, 2009)

On a Medicare screening pelvic and breast exam (G0101), is it a requirement to perform the breast exam or can the exam include at least 7 of the 11 elements without examination of the breast? Thank you!


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## aguelfi (Nov 2, 2009)

CMS states that a breast exam is no longer required in order to report G0101, however you still must perform at least 7 of the required 11 elements below in order to report G0101:

 • Inspection and palpation of breasts for masses or lumps, tenderness, symmetry or nipple discharge

• Digital rectal examination including sphincter tone, presence of hemorrhoids, and rectal masses

• External genitalia (for example, general appearance, hair distribution or lesions)

• Urethral meatus (such as size, location, lesions, or prolapse)

• Urethra (for instance, masses, tenderness or scarring)

• Bladder (for example, fullness, masses or tenderness) 

• Vagina (e.g., general appearance, estrogen effect, discharge, lesions, pelvic support, cystocele or rectocele) 

• Cervix (for example, general appearance, lesions or discharge) 

• Uterus (such as size, contour, position, mobility, tenderness, consistency, descent or support) 

• Adnexa/parametria (for instance, masses, tenderness, organomegaly or nodularity)

• Anus and perineum.


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## tkeeton7885 (Nov 4, 2009)

Thank you for the response! This has been my understanding also, however, our auditor pointed out in the the Guide to Medicare Preventive Services July 2009 the following statement: 'the pelvic examination includes a clinical breast examination, which aids in helping to detect and find breast cancer or other abnormalties.' Any ideas?? Thanks!


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## aguelfi (Nov 5, 2009)

Ask for them to specify what they mean by that and show them CMS' statements.


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## kamkole (Dec 3, 2009)

We are being instructed that the breast exam is a *required* element, but I'm curious to see how others feel.  I still feel it isn't required and is optional to be one of the 7 of 11 elements.


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