Wiki Paps

Create Wiki
D

Dorthi

Networker
Messages
74
Location
Colorado Springs, CO
Best answers
0
We are a PCP office, when I bill an annual physical and pap the physical is paid but not the pap. Anyone else have this issue or what are you doing to get paid for this. I use the Q0091 and G0101 for the paps. Thanks for any help.

Dorthi
 
It's my understanding the G and the Q codes are only for Medicare. When we have a commercial insurance pap/pelvic/breast are considered part of a full physical. We use the V72.31 diagnosis code as well as the V70.0 but we don't break them out and bill separate. I hope this helps and will be interested to see what others are doing :)
 
Dorthi said:
I have not seen that anywhere else so I am very interested to know as well.

Thanks for your response.
Click to expand...

Ahanna is correct. The Q and G codes are for Medicare patients. Q0091 is for the pap and keep in mind that a pap is only covered every 2 years unless the patient is considered high risk. G0101 is for a "Well woman" exam which covers a pelvic and breast exam. The doctor must document at least 7 of the eleven pelvic elements as well as the breast exam to bill for this code.

A patient with commercial insurance would be billed out with the E/M code for a well visit with the appropriate V codes.

Hope that helps! :)
 
Pap and Pelvic Exam

we are not the patients PCP and perform a pap and pelvic exam. she has commercial insurance. can I still bill for an annual exam? Patient came in with complaints of hot flashes and a check up on hormone creams. Physician also obtained a smear to be sent to an outside lab.
 
You must log in or register to reply here.
Top