Wiki annual exam coding

[lminneti]

hi all
I have question on coding. pt comes in to ob dr and has her annual exam done. in the dr note he states visit type as annual exam but for the dx he states encounter for routine gyn exam w/pap of cervix plus vaginal pap smear. how would this be coded so that the insurance pays it?

 

[danskangel313]

hi all
I have question on coding. pt comes in to ob dr and has her annual exam done. in the dr note he states visit type as annual exam but for the dx he states encounter for routine gyn exam w/pap of cervix plus vaginal pap smear. how would this be coded so that the insurance pays it?

You should never code with the intent to make sure something gets paid. You need to code strictly from the documentation. The provider listed both the service "annual exam" and the DX "encounter for routine gyn exam w/pap of cervix plus vaginal pap smear". I'm not quite sure where you're stuck at. Can you provide more information?

 

[Shabeer]

Code as Routine Annual Exam

Code as Routine Preventive visit -- For Non Medicare payer 99381 -- 99397 and for Medicare G0402, G0438, G0439 with the Pap Smear test code