BILLING MEDICARE ANNUAL WELLNESS VISITS FOR WOMEN

[joyce]

Does anyone know how to code the pap smear with the G0438 for medicare's annual wellness visit?

I previously coded with Q0091, but they don't seem to like it, stating it is medically un-necessary.

Thanks, Joyce

[supertaz93]

According to Medicare
Q0091 Screening Pap smear;
obtaining, preparing and
conveyance to lab
Report one of the
following codes:

Low Risk – V72.31, V76.2,
V76.47, V76.49

High Risk – V15.89

All female Medicare beneficiaries
•
•
Annually if at high risk
for developing cervical
or vaginal cancer, or
childbearing age with
abnormal Pap test within
past 3 years
Every 24 months for all
other women

http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/MPS_QuickReferenceChart_1.pdf  pg. 2

Without knowing more details, I would assume 3 things could be wrong 1) one of the above dx was not used or 2) the patient has a low risk dx but has had a pap within 24 months or 3) patient is high risk but paps were less than a year apart.

[joyce]

Oh great, thanks, I understand!

You're much appreciated!!!