Ob-Gyn Coding Alert

Question: We have billed Medicare for well-woman care (using G and Q codes), not knowing at the time that the patient had another Cigna Indemnity plan that we needed to bill first. So now we need to file the claim with Cigna before we send it to Medicare. Do I just send the claim on to Cigna with the G and Q codes or remove them and file for just the E/M visit?

Colorado Subscriber

Answer: Cigna does not process the G and Q codes, so just bill them the 99xxx. If the patient has wellness coverage, Cigna will pay her allowable for the service, but it is unlikely that you will have anything left to bill Medicare, as Cigna will have paid for the entire service. Only if Cigna denies the preventive service can you go to Medicare as the secondary payer for the G and Q codes.

Answers to You Be the Coder and Reader Questions provided by Melanie Witt, RN, CPC, MA, an independent coding consultant and ob/gyn coding expert based in Fredericksburg, Va.