Author Topic: Coding Medicare Breast exam  (Read 1145 times)

Meli

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  • Melissa Turner
    • Mainstream Services Inc.
Coding Medicare Breast exam
« 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. 
Melissa Turner, CPMB
Mainstream Services Inc.
www.msmbinc.com

oneround

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Re: Coding Medicare Breast exam
« Reply #1 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? 
Michael A. Reynolds, CPC, CCP-P, CPMB, OS
Project Manager
Corporate Compliance
Sharp HealthCare

Meli

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  • Melissa Turner
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Re: Coding Medicare Breast exam
« Reply #2 on: November 01, 2010, 03:45:58 PM »
It was coded as v72.31 but the notes specifically state no pelvic, breast exam only. 
Melissa Turner, CPMB
Mainstream Services Inc.
www.msmbinc.com

oneround

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Re: Coding Medicare Breast exam
« Reply #3 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.
Michael A. Reynolds, CPC, CCP-P, CPMB, OS
Project Manager
Corporate Compliance
Sharp HealthCare