Ob-Gyn Coding Alert

Applying this modifier alerts Medicare that you know the service isn't covered.To estimate what your practice should charge a Medicare patient when your ob-gyn performs a preventive service as well as an E/M service at the same visit means applying the "carve out" rule. Depending on whether the patient's annual exam is covered, your outcome will be very different.Our experts break this sometimes puzzling rule into terms you can understand.Follow This Advice for Medicare CarriersFor Medicare beneficiaries, you should take your normal charge amount of the preventive service minus the charge amount for the sick visit. This will give you the total amount you can bill the patient for the preventive part of the visit.Example: A 66-year-old established patient comes in for her yearly exam. Last year when she presented for her annual exam, you billed Medicare for the breast, pelvic, and Pap, and it was reimbursed. Remember: "Medicare will [...]