Wiki Urgent help!!!!!!!!

[NishaJ]

Hi...
Anyone can make me understand the BASIC coding Concept of hcpcs G0101, Q0091 and how to bill these service for Medicare and Non medicare service and Dx coding ....

Please share with me if you have any useful websites....

Thanks,
NJ

 

[Chelle-Lynn]

I have attached a user friendly training from Medicare Learning Network on these codes. Not sure if you have already looked at this option or not. I usually find the Medicare Learning Network to have the most straight forward information.

https://www.cms.gov/Outreach-and-Ed...ownloads/Screening-PapPelvic-Examinations.pdf

 

[NishaJ]

Hello chelle,

I didn't notice this guide. I hope that this will be helpful for me. Thanks for your immediate reply and guidance.

Thanks,
NJ

 

[Chelle-Lynn]

You are welcome. The Medicare Learning Network usually has the most straightforward information. If this does not answer your questions, please let me know and I will see what else we have. We bill for these services on a regular basis so we are fairly familiar with the guidelines.

 

[smoore123]

Hi NJ,

There are documentation requirements to meet for billing the breast and pelvic exam:

Should include at least seven of the following eleven elements:
- Inspection and palpation of breasts for masses or lumps, tenderness, symmetry, or nipple discharge.
- Digital rectal examination including sphincter tone, presence of hemorrhoids, and rectal masses. Pelvic examination (with or without specimen collection for smears and cultures)
- External genitalia (for example, general appearance, hair distribution, or lesions).
- Urethral meatus (for example, size, location, lesions, or prolapse).
- Urethra (for example, masses, tenderness, or scarring).
- Bladder (for example, fullness, masses, or tenderness).
- Vagina (for example, general appearance, estrogen effect, discharge lesions, pelvic support, cystocele, or rectocele).
- Cervix (for example, general appearance, lesions, or discharge).
- Uterus (for example, size, contour, position, mobility, tenderness, consistency, descent, or support).
- Adnexa/parametria (for example, masses, tenderness, organomegaly, or nodularity).
- Anus and perineum

 

[NishaJ]

Thank you so much stephanie.

 

[NishaJ]

I have few more doubts....

When we have billed Q0091 to non -medicare payer , we could see denials for Q0091 as bundled. I have a doubt , whether we can bill 99000 instead of Q0091...

And another doubt, if a patient came for Screening , we have billed with Q0091. Incase if a patient is having cervix cancer, and now came for Diagnostic PAP means, how we can bill this visit . Can we bill Q0101 for this case.
Thanks in advance....

NJ

 

[NishaJ]

In what cases, we can use the codes 88174, 88175, G0123, G0143, G0144, etc..