Q0091-Pap



I routinely bill this code with a screening diag code of Z12.4. However,
most payers won't pay it when coupled with an annual visit daig code of
Z01.411/Z01.419 stating it is included in annual visit. Is there a trick to
getting this pap code paid at the same time as an annual?

If we bring the patient back for a pap yearly due to abnormal cells, we
have no problem getting it paid with the office visit code. Just thought I
would check.


Kara L. Andrews, R.M.A.
Practice Manager
Gynecology of Venice, P.L.
241 Nokomis Ave. S., Ste. A
Venice, FL 34285
941-485-9941





Comments

  • Q0091 was specifically set up by Medicare for procuring the sample for screening Pap smears. ACOG considers that work to be part of the annual physical. So for payers that follow Medicare guidelines you may get paid. The payers that are denying are following ACOG's lead. Frankly I think ACOG is correct and never could figure out why Medicare chose to pay additional monies for it. But it is not often that Medicare gives more!

    Sent from my iPhone

    > On Jan 31, 2017, at 6:13 AM, Kara Mikluscak wrote:
    >
    > I routinely bill this code with a screening diag code of Z12.4. However, most payers won't pay it when coupled with an annual visit daig code of Z01.411/Z01.419 stating it is included in annual visit. Is there a trick to getting this pap code paid at the same time as an annual?Â
    >
    > If we bring the patient back for a pap yearly due to abnormal cells, we have no problem getting it paid with the office visit code. Just thought I would check.Â
    >
    >
    > Kara L. Andrews, R.M.A.
    > Practice Manager
    > Gynecology of Venice, P.L.
    > 241 Nokomis Ave. S., Ste. A
    > Venice, FL 34285
    > 941-485-9941
    >
    >
    > Â
    >
    > Â Â
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    Q0091 was specifically set up by Medicare for procuring the sample for screening Pap smears.  ACOG considers that work to be part of the annual physical.  So for payers that follow Medicare guidelines you may get paid.  The payers that are denying are following ACOG's lead.  Frankly I think ACOG is correct and never could figure out why Medicare chose to pay additional monies for it. But it is not often that Medicare gives more!

    Sent from my iPhone
    On Jan 31, 2017, at 6:13 AM, Kara Mikluscak <kmikluscak1@gmail.com> wrote:
    I routinely bill this code with a screening diag code of Z12.4. However, most payers won't pay it when coupled with an annual visit daig code of Z01.411/Z01.419 stating it is included in annual visit. Is there a trick to getting this pap code paid at the same time as an annual? 
    If we bring the patient back for a pap yearly due to abnormal cells, we have no problem getting it paid with the office visit code. Just thought I would check. 

    Kara L. Andrews, R.M.A.
    Practice Manager
    Gynecology of Venice, P.L.241 Nokomis Ave. S., Ste. A
    Venice, FL 34285941-485-9941


     
      

    Notice: The information contained in this electronic mail transmission is intended for the use of the named individual or entity to which it is directed and may contain information that is privileged or otherwise confidential. It is not intended for transmission to, or receipt by, anyone other than the named addressee (or a person authorized to deliver it to the named addressee). It should not be copied or forwarded to any unauthorized persons. If you have received this electronic mail transmission in error, please delete it from your system without copying or forwarding it, and notify the sender of the error by reply email so that the address record can be corrected. HIPAA Compliance Disclosure: The documents accompanying this e-mail transmission contain confidential information belonging to the sender that is legally privileged. The information is intended only for the use of the individual or entity named above. The authorized recipient of this information is prohibited from disclosing this information to any other party and is required to destroy the information after its stated need has been fulfilled, unless otherwise required by state law.



     
     
     
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