Wiki E/M w/Preventive Dx

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CPalmer

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Senario: 71yo Medicare pt came in b/c it had been 3 yrs since her last pap test for HPV. Our doctor billed an e/m-25 code w/V70.0 and a pap w/V76.2. Is this acceptable? Medicare isn't covering either. Not worried about the pap, only the office visit. Please advise.
 
If he/she only did a pap and breast/pelvic exam then you have G0101 and Q0091 only. If only a pap was obtained and no other type of physical performed, this would be Q0091 only. An E/M code with V70.0 is inappropriate and Medicare does not pay for preventive codes (99397).
 
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