Please I need some help with this. if a patient comes for a Pap smear with his PCP and there is no any other complains should I use Q0091 since the EM code can not be use because there is no any other diagnosis o complains?? Or theses Codes Q0091 and G0101 should be only use with medicare patients?
Basically, it depends what services you are providing. Did the PCP perform an annual well woman (breast exam, pelvic exam, contraception discussion, family planning, screening, counseling, etc) in addition to the PAP? If so, then 99381-99397 are appropriate E/M codes with dx
Z01.419, Encounter for gynecological examination (general) (routine) without abnormal findings (or Z01.411 if there were abnormal findings). If the clinician just took the PAP sample without providing additional services, then you should not bill for them.
G0101 I have seen covered by some commercial carriers, but most ob/gyns are billing the 99381-99397 instead for an annual well woman.
Q0091 is used by Medicare as well as commercial carriers. Some payors will bundle the Q0091 into an E/M.
Here's a great link going further into detail
https://codingintel.com/billing-pap-smear/
I will make a side note since it is the PCP, many insurances will only pay 1 well exam per year to PCP. If the patient already came in within the year for annual well exam and you already billed 99381-99397, you may not get it covered a second time. POSSIBLY with appeal and showing the diagnosis of gynecological exam.
I will make another side note that in my area, it would be highly unusual for a PCP to do a PAP (like I've never seen it once in 16 years highly unusual). They would refer the patient to an ob/gyn and wouldn't even have the stirrups, speculum, PAP brush, etc. if the patient requested the service. In other parts of the country (particularly more rural areas with less access to ob/gyn care), it is a more common practice.