Wiki Billing Breast Exam and Pap Smear

[Sandra.mitchell]

We have a OBGYN in Texas who is seeing Medicare patients for their preventative visit, a breast exam, and a pap smear. However, we will bill Medicare to find out the patient has already had their preventative visit with their PCP but requested to have the breast exam and pap smear done by our doctor.

What is a good way to handle these patients, especially since we typically find out about the PCP visit after we have already billed for these services. Is there a way we can get paid for just doing the breast exam and the pap smear if the preventative was done by someone else? Or should we have these patients sign an ABN just in case?

 

[drtmod40]

I would always make sure a ABN is signed just incase it is ever denied and it wont get paid. Breast/pap are only covered every 2 years unless high risk then you would use high risk dx. If there is enough documentation to support a E/M level you can bill an E/M