Wiki Preventative Visit E&M and Q0091??

[Marje]

I have not been able to find a clear answer for the following question:

If a patient (non-Medicare) goes to her PCP (not OBGYN) and has her Yearly Physical and a Pap, is the Pap included in the Preventative Visit E&M or is it coded seperatly with Q0091? Does anyone have any guidelines they could direct me to?
Any help is appreciated.
Thanks-

 

[AC32333]

ACOG Position

The American Congress of Obstetricians and Gynecologists states the following in an article entitled, Coding Tip Reporting HCPCS Code Q0091 Screening Papanicolaou smear obtaining preparing and conveyance of cervical or vaginal smear to laboratory:

Non-Medicare Payers:

HCPCS Code Q0091 should not be reported to private payers for pap smear collection. The collection of a pap smear is included in the E/M or preventive medicine service.

http://www.acog.org/

 

[ajgibson]

I think it depends on the payer. Some Michigan Medicaids have it payable on their fee schedule.
Also, Health Plus has it payable with a -59 modifer if done in conjunction with a Preventative visit, on their clear claims connection.

Check with you payers! Hope that helps.