Ob-Gyn Coding Alert

Question: I understand Medicare requires seven of 11 elements to bill for a screening pelvic exam. When counting elements for the pelvic exam portion of an annual wellness exam, does -cervix absent- or -uterus absent- count as an element? 

California Subscriber

Answer: Are you talking about the preventive medicine guidelines or reporting G0101 (Cervical or vaginal cancer screening; pelvic and clinical breast examination)? 

When you bill G0101 to Medicare, you get to count the cervix or uterus as an element of the exam if it is absent and the physician documents this.  

For the preventive medicine exam, the Medicare guidelines do not apply, and you should base the exam on what the physician has to examine.