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Posted By Mary Peabody on 02-06-2020, 20:21:47 in Ob-Gyn
Hello Melanie

If a patient was seen by her Primary Care Physician for an annual checkup, no pelvic or breast examination and the visit was billed with the preventive CPT code 99395 with DX Z00.00. Patient returns two weeks later and sees a Primary Care NP in the same practice for a breast and pelvic examination and pap smear, do you bill this visit with a problem E/M with the DX Z12.4. Patient did not want the Primary Care Physician to perform the pelvic examination. The insurance is also commercial so Q0091 is not billable.
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Posted By Melanie Witt on 02-17-2020, 18:32:34
First, you need to have some conversations with your patients about this. You are not going to get reimbursed for 2 preventive visits in the same practice within 2 weeks of each other. For the second visit, bill a problem E/M linked to both Z12.4 and Z12.39 and keep your fingers crossed. Every female patient, when scheduling an annual, needs to be informed that they might have to pay out of pocket for the second visit and schedule the annual with a provider she feels comfortable with for the Pap and breast exam.
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