A screening pelvic examination (G0101) with or without specimen collection for smears and cultures, should include at least seven of the following eleven elements:
o Inspection and palpation of breasts for masses or lumps, tenderness, symmetry, or nipple discharge; and
o Digital rectal examination including sphincter tone, presence of hemorrhoids, and rectal masses.
o External genitalia (for example, general appearance, hair distribution, or lesions);
o Urethral meatus (for example, size, location, lesions, or prolapse);
o Urethra (for example, masses, tenderness, or scarring);
o Bladder (for example, fullness, masses, or tenderness);
o Vagina (for example, general appearance, estrogen effect, discharge, lesions, pelvic support, cystocele, or rectocele);
o Cervix (for example, general appearance, lesions or discharge)
o Uterus (for example, size, contour, position, mobility, tenderness, consistency, descent, or support);
o Adnexa/parametria (for example, masses, tenderness, organomegaly, or nodularity); and
o Anus and perineum.
**Note** You bill the G0101 for "screening" pelvic exams. Your problem addressed was for Menopausal Uterine Bleeding so, that is why they're saying to remove the G0101 and Q0091 as it wouldn't be applicable in your scenario.