Ob-Gyn Coding Alert

Question: If my ob-gyn sees a Medicare patient for a breast and pelvic exam, but the documentation does not qualify for the seven of 11 elements to bill the G0101 code, should I bill the wellness code instead? Also, if my ob-gyn did a Pap smear, should I still bill Q0091 with 99397, instead of billing it the usual way of G0101 and Q0091? North Dakota Subscriber Answer: Ask, why isnt your ob-gyn documenting seven of the 11 required elements to get paid? This suggests poor documentation. If your ob-gyn routinely does not document the required elements, then you cannot bill G0101 (Cervical or vaginal cancer screening; pelvic and clinical breast examination). The patient will be responsible for the entire non-covered service. If this is a covered year, then the patient will be very unhappy. You can bill Q0091 (Screening Papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal [...]