Scribd Logo
Importer

Bienvenue sur Scribd !

  • For Pap Smears at Annual Physicals, Medicare Does Its Own Thing

    Transféré par

    Sam Nair
    13 vues3 pages
    The Coding Institute, Coding Tips: For decades, Pap smears have been physicians’ best tools to screen for cervical and vaginal cancer, and Medicare’s benefits include this very test, as well as pelvic and clinical breast examination. But though Medicare reimburses for these screening examinations as Medicare benefits, it does not normally reimburse CPT® preventive screening codes such as 99396 (Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 40-64 years).

    Copyright

    © © All Rights Reserved

    Formats disponibles

    PDF, TXT ou lisez en ligne sur Scribd

    Avez-vous trouvé ce document utile ?

    Ce contenu est-il inapproprié ?

    Signaler ce document
    The Coding Institute, Coding Tips: For decades, Pap smears have been physicians’ best tools to screen for cervical and vaginal cancer, and Medicare’s benefits include this very test, as well as pelvic and clinical breast examination. But though Medicare reimburses for these screening examinations as Medicare benefits, it does not normally reimburse CPT® preventive screening codes such as 99396 (Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 40-64 years).

    Droits d'auteur :

    © All Rights Reserved
    Téléchargez comme PDF, TXT ou lisez en ligne sur Scribd
    Signaler comme contenu inapproprié
    13 vues3 pages

    For Pap Smears at Annual Physicals, Medicare Does Its Own Thing

    Transféré par

    Sam Nair
    The Coding Institute, Coding Tips: For decades, Pap smears have been physicians’ best tools to screen for cervical and vaginal cancer, and Medicare’s benefits include this very test, as well as pelvic and clinical breast examination. But though Medicare reimburses for these screening examinations as Medicare benefits, it does not normally reimburse CPT® preventive screening codes such as 99396 (Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 40-64 years).

    Droits d'auteur :

    © All Rights Reserved
    Téléchargez comme PDF, TXT ou lisez en ligne sur Scribd
    Signaler comme contenu inapproprié
    sur 3

    For Pap Smears at Annual Physicals, Medicare

    Does Its Own Thing


    By Susan Dooley

    For decades, Pap smears have been physicians best tools to screen for cervical and vaginal cancer, and
    Medicares benefits include this very test, as well as pelvic and clinical breast examination. But though
    Medicare reimburses for these screening examinations as Medicare benefits, it does not normally
    reimburse CPT preventive screening codes such as 99396 (Periodic comprehensive preventive medicine
    reevaluation and management of an individual including an age and gender appropriate history,

    The Coding Institute LLC, 2222 Sedwick Road, Durham, NC 27713, Eenterprise Contact: Sam Nair, Direct: 704 303 8150,
    shyamn@codinginstitute.com

    examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of


    laboratory/diagnostic procedures, established patient; 40-64 years).
    But never fear HCPCS level II codes are here! No, seriously, CMS created separate HCPCS Q and G
    codes to cover these benefits. For that reason, when your providers perform screening Papanicolaou
    smears or cervical or vaginal screenings, you should report the following:

    Q0091, Screening Papanicolaou smear; obtaining, preparing and conveyance of cervical or


    vaginal smear to laboratory
    G0101, Cervical or vaginal cancer screening; pelvic and clinical breast examination.

    Use Q0091 to report to Medicare a screening Papanicolaou smear when your provider obtains it,
    prepares it, and sends it to the lab. Use G0101 to report to Medicare that a cervical or vaginal
    cancerscreening and pelvic and clinical breast examination has been performed.
    Note that these tests are covered once every 24 months for all women Medicare beneficiaries and once
    every 12 months for women at high risk for cervical or vaginal cancer. If women Medicare beneficiaries
    are of childbearing age and have had an abnormal Pap test in the preceding 36 months, they too are
    eligible for these screening tests every 12 months.

    Dont Forget the Diagnosis Code!


    Of course youll need to include the appropriate ICD-10-CM code with your claim for these HCPCS codes.
    For patients who are at a low risk level for cervical or vaginal cancer, report the appropriate code from
    the following choices:

    Z01.411, Encounter for gynecological examination (general) (routine) with abnormal findings
    Z01.419, Encounter for gynecological examination (general) (routine) without abnormal findings
    Z12.4, Encounter for screening for malignant neoplasm, cervix
    Z12.72, Encounter for screening for malignant neoplasm, vagina
    Z12.79, Encounter for screening for malignant neoplasm, other genitourinary organs
    Z12.89, Encounter for screening for malignant neoplasm, other sites.

    For patients at high risk, youll choose from among these diagnosis codes:

    Z72.51, High-risk heterosexual behavior


    Z72.52, High-risk homosexual behavior
    Z72.53, High-risk bisexual behavior
    Z77.22, Contact with and (suspected) exposure to environmental tobacco smoke
    Z77.9, Other contact with and (suspected) exposures hazardous to health
    Z91.89, Other specified personal risk factors, not otherwise classified
    Z92.89, Personal history of other medical treatment.

    The Coding Institute LLC, 2222 Sedwick Road, Durham, NC 27713, Eenterprise Contact: Sam Nair, Direct: 704 303 8150,
    shyamn@codinginstitute.com

    Got Pap Tips?


    Got tips for success in reporting screening Papanicolaou smears? Let us know!

    Stay Compliant and Fast With Fast Coder!


    Need to keep your Medicare rules straight? When you subscribe to SuperCoders Fast Coder, you can
    check fees, crosswalk between ICD-9-CM and ICD-10-CM codes, and check out the diagnosis and CPT
    codes submitted most frequently together for Medicare and private payer claims. Best of all, you can
    search across ICD-10, ICD-9, CPT, and HCPCS codes and you can stay compliant with CCI, NCDs, and
    LCDs. Contact us for your trial access today!

    Contact Us:
    Name: Sam Nair
    Title: Associate Director Enterprise Practice
    Email: shyamn@codinginstitute.com
    Direct: 704 303 8150

    Desk: 866 228 9252, Ext: 4813


    The Coding Institute LLC, 2222 Sedwick Road, Durham, NC 27713

    The Coding Institute LLC, 2222 Sedwick Road, Durham, NC 27713, Eenterprise Contact: Sam Nair, Direct: 704 303 8150,
    shyamn@codinginstitute.com

    Vous aimerez peut-être aussi