Wiki OB/GYNE Help

[gsereda]

Just wondering if anyone can give me some good resources for OB/GYNE coding and billing.
We have just turned into a new MultiSpec. group and have a new OB/Gyne starting. I have been in Family Practice for 26 years and would love some guidance. Any help would be greatly appreciated. Thanks so Much!

 

[tanderson@MCS]

Coding companion

Optum AKA ingenix has a wonderful book called OB-GYN coding companion, also enroll in list serves on coding911.com for ob/gyn.

 

[gsereda]

Thank you so much. I feel so in the dark with this OB/GYN coding

 

[dcrossman]

ACOG (American Congress of Obstetricians and Gynecologists) has some great resources. My favorites are: The Essential Guide to Coding in Obstetrics and Gynecology (ISBN: 978-1-932328-40-) and Frequently Asked Questions in Obstetric and Gynecologic Coding (ISBN: 978-1-935718-02-4). I refer to mine frequently.

 

[Ravenlock621@aol.com]

annual gyne exam coding for Medicare

i am new to ob/gyne coding and am having trouble coding the well woman annual exam with pap smear for medicare pts. my predescessor billed as a regular E&M visit, as so many of the patients have multiple complaints beyond a basic well woman exam and pap smear visit. the problem is that with the new health care laws, annual exams are not subject to deductibles and co-pays, and billing with a regular E& M code will trigger this. I am told that medicare does not use the preventive medicine 99384 to 99387 , or 99394 to 99397 cpt codes. Does anyone have an example of how a typical medicare well woman annual visit should be coded? Also, are the pap smears now bundled into the annual so that we no longer have to keep track for billing every other year for the pap smear? I would really appreciate some guidance. Thanks!

 

[Anastasia]

You may bill the 993-- codes to Medicare but it will not be covered and the patient will be responsible. This would have to be explained to the patient prior to her exam and an ABN should be signed.

 

[jdibble]

A Medicare well woman exam is the Pelvic/Breast exam and pap (one every 2 years) if done - and they will pay for this. To bill for these you would need to have reviewed at least 7 of the 11 "bullets" of the pelvic area and do a breast exam - then use G0101 for the pelvic and if a pap is done, use Q0091. If the patient is on an inbetween year for her pap, you would still use the same code but would have the patient sign and ABN and then use the GA modifier.