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Medicare annual & problem visit?

Susan Posted Thu 09th of March, 2017 11:39:16 AM
If patient is scheduled for annual exam but more than 50% of the visit is actually problem oriented I was informed we should then bill as problem visit. Can we also then bill the Q0091 collection of pap smear? What about the G0101 if most of these elements may have been included in the problem visit exam?
SuperCoder Answered Fri 10th of March, 2017 06:32:15 AM

As the above documentation indicates, that the visit was problem centric. So you need to bill appropriate office visit E/M code along with modifier -25. Also, bill HCPCS code Q0091 and G0101 separately as they are not included in the E/M code.

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