RE: Re: Medicare GYN billing

[Guest guest]

Soma

That is a tricky one. There is no such thing as a “regular

GYN visit” and don’t forget that Medicare doesn’t pay for

physicals.

So you can bill the appropriate E & M code for the level of

care. Then there are special CPT codes for collection of PAP (Q0091) and

Breast and Pelvic exam (G0101).

Now Medicare patient is only entitled to a PAP every 35

months. And, theoretically the G code for Breast and Pelvic exam isn’t

allowed to be billed with any other E & M code, but you could try billing

with a -25 modifier on the E & M and completely separate ICD-9 codes (like

other conditions you see the patient for.

For a GYN exam, the ICD-9 I use is V72.31. and V76.19 is

Screening Breast Exam although I never bother using that.

Kathy Saradarian, MD

Branchville, NJ

www.qualityfamilypractice.com

Solo 4/03, Practicing since 9/90

Practice Partner 5/03

Low staffing

From:

[mailto: ] On Behalf Of Soma Mandal

Sent: Monday, January 07, 2008 4:38 PM

To: Yahoo Practive Improvement

Subject: Re: Medicare GYN billing

Hey folks,

Can anyone tell me how to bill a regular gyn visit

with medicare including ICD-9 and CPT code?

Gracias.

Soma

[Guest guest]

Thanks a bunch Kathy.

Soma

--- Kathy Saradarian wrote:

> Soma

>

> That is a tricky one. There is no such thing as a

> " regular GYN visit " and

> don't forget that Medicare doesn't pay for

> physicals.

>

>

>

> So you can bill the appropriate E & M code for the

> level of care. Then

> there are special CPT codes for collection of PAP

> (Q0091) and Breast and

> Pelvic exam (G0101).

>

> Now Medicare patient is only entitled to a PAP every

> 35 months. And,

> theoretically the G code for Breast and Pelvic exam

> isn't allowed to be

> billed with any other E & M code, but you could try

> billing with a -25

> modifier on the E & M and completely separate ICD-9

> codes (like other

> conditions you see the patient for.

>

>

>

> For a GYN exam, the ICD-9 I use is V72.31. and

> V76.19 is Screening Breast

> Exam although I never bother using that.

>

>

>

>

>

> Kathy Saradarian, MD

>

> Branchville, NJ

>

> www.qualityfamilypractice.com

>

> Solo 4/03, Practicing since 9/90

>

> Practice Partner 5/03

>

> Low staffing

>

>

>

>

>

>

>

> From:

> [mailto: ] On

> Behalf Of Soma Mandal

> Sent: Monday, January 07, 2008 4:38 PM

> To: Yahoo Practive Improvement

> Subject: Re: Medicare GYN

> billing

>

>

>

> Hey folks,

>

> Can anyone tell me how to bill a regular gyn visit

> with medicare including ICD-9 and CPT code?

>

> Gracias.

>

> Soma

>

>

>

>