Medical Billing Forum

Coding => Coding => Topic started by: Meli on October 31, 2010, 05:19:21 PM

Title: Coding Medicare Breast exam
Post by: Meli on October 31, 2010, 05:19:21 PM
I am reviewing encounters provided for billing and came across one that is a Medicare patient and the note is that a breast exam only noting 99397 was done.  What is the correct ICD for a breast only exam? V72.31 is provided however this is for a breast and pelvic exam.  The pelvic was not done. 
Title: Re: Coding Medicare Breast exam
Post by: oneround on November 01, 2010, 03:03:37 PM
  V76.10 if no  pelvic
  V72.31 breast,pelvic w/wo smear

  Based upon information given.  What is your coder coding it as? 
Title: Re: Coding Medicare Breast exam
Post by: Meli on November 01, 2010, 03:45:58 PM
It was coded as v72.31 but the notes specifically state no pelvic, breast exam only. 
Title: Re: Coding Medicare Breast exam
Post by: oneround on November 02, 2010, 11:01:52 AM
may want to confir with your peer then as she/he may be seeing something in the pt chart to support the breast/pelvic ICD.  But based upon the info given I would code it as the breast exam only in no pelvic or pap was performed.