Wiki Collection of Pap Smear and E/M Visit on Same Day

[JCampbell]

If a patient comes in for a repeat pap is it appropriate to bill both an e/m visit and collection of specimen (Q0091)? We have billed both and are receiving a denial from the insurance stating that the e/m is being bundled with the Q0091. I know that a 25 modifier will unbundle the service but am uncertain on using this modifier for this particular situation.


Thanks for any help that you may be able to give.

Jennifer

 

[sparkles1077]

If it is a diagnostic pap, it is bundled with the E and M and the Q0091 should not be used.

If it is a screening pap, it can be billed (ICD9 should be reflective)

 

[smontague]

If they are being seen for a separate issue in addition to the repeat pap, then yes you can bill the E/M and add -25 modifier, but if the repeat pap is the only reason, then bundling is correct.