Wiki CPT Q0091 pap collection

[jhendrix08]

Hi!

Can anyone provide some advice on billing Q0091 for pap collection & specimen handling?

Do you have to add a modifier to the code when you bill it with the Preventive Annual Exam code? For instance, 99396 with Q0091. My understanding was that the Q code was not able to be billed separately. (?)

Experience with reimbursement? I know this is typically used for Medicare; what about commercial payers?

Thanks so much!

 

[ahguzman]

Coverage guidelines vary from payer to payer for Q0091. Some will reimburse and others consider it to be part of the E&M. ACOG recommends that Pap smear collection is an included component of the exam. Medicare follows the same rule if collected for diagnostic and not screening.


AHG,
CPC, CPMA

 

[jhendrix08]

I really appreciate you taking the time to reply; thanks for the help!!