I thought this Q&A was eductional!
Ob-gyn coder says:
Medicare pt came in for a wwe & pessary cleaning. The initial visit was to be for pessary cleaning only, but dr did a well also, We billed medicare g&q codes w/ a e/m for pessary cleaning w/ 25. Mediare pd & sent to uhc for 2ndary, which they kicked to pt resp for copays. Well the pt called and said she did not have a mammogram done in the office. The 'G0101' is for screening of pelvic & breast, so should we have not billed for the g0101 if pt did not have a breast exam done? No abn was signed.
Melanie Witt answers:
The G code is for a pelvic exam which no longer has to include a breast exam, not a mammogram. You billed correctly. Copays and deductibles are the patient responsibility unless her secondary picks those up as part of what they pay.
