Wiki reimburement for well women and pap

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mokeyg

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Does anyone know which carriers reimbure for both the well women exam , 99395, 99396 etc along with the taking of the pap Q0091? This is a huge cost at our ofice and we always get the Q0091 denied as incorrect billing by most companies. Some of the smaller carriers have paid. Anyone help or advice is greatly appreciated!
 
If it is a well woman you cannot bill both the preventive E&M and the Q0091 you can bill either the preventive code OR the Q0091 and the G0101. The PAP is inclusive with the preventive code.
plus Mcare does not reimburse the preventive CPT code. They will pay the G0438/9 and the G0101 and Q0091 however.
If you are doing the regular preventive and a well woman for other than Mcare you can use the preventive and link to the V70.x and the the Q0091 and G0101 and link to the V72.31, many commercial will allow this and pay.
 
So the G codes for the well woman pap are covered by any ins company? Not just medicare.
example, woman comes in for her wellness physical 993XX, then decides the next day she wants her yearly OB exam and comes back....do only you code 992XX/ V72.31.... or the G code only, and UHC and/or Cigna pay those codes?
 
I have a couple of questions that I need clarification. If I were to go and see my PCP and she did a preventative, I would bill the 993XX with ICD 9 code V700. If I went to my OB/GYN for my annual wellness, I would bill G0101 with V7231 & Q0091 with V762. Is this correct?

Has anyone billed and received payment for HCPCS codes S0610, S0612 or S0613?

Any assistance would be greatly appreciated as I just started billing for our GYN?

Thanks, Tami Laubhan, CPC
 
I was under the impression the the G0101 and Q0091 was for Medicare only. Is this not true?
When we do WWE I usually charge for the 993xx and if pap is obtained 99000 with the
V72.31 Dx code. The patient fills out a complete HPI and ROS and the physician does a full exam and depending on findings the patient is either scheduled to return in 12 months or 24 months if all is normal.
 
The G and the Q codes are carrier discretion allowed. You need to check with the individual carriers as to which codes they prefer for the well woman
 
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