Deductible and Coinsurance for Screening Pelvic Examinations (Rev. 1541, 09-23-08)

by  Jared Staheli
June 29th, 2015

The Part B deductible for screening pelvic examinations is waived effective January 1, 1998. Coinsurance is applicable.

A. Action When Submitting Claims to CWF and CWF Edit

When a carrier receives a claim for a pelvic examination, performed on or after January 1, 1998, it must enter a deductible indicator of 1 (not subject to deductible) in field 65 of the HUBC record.

When an FI receives a claim for a screening pelvic examination (including a clinical breast examination), performed on or after January 1, 1998, it reports special override Code 1 in the “Special Action Code/Override Code” field of the CWF record for the line item, indicating the Part B deductible does not apply.

CWF edits for screening pelvic examinations performed more frequently than allowed according to the presence of high risk factors.


Deductible and Coinsurance for Screening Pelvic Examinations (Rev. 1541, 09-23-08). (2015, June 29). Find-A-Code Articles. Retrieved from

© InnoviHealth Systems Inc

Article Tags  (click on a tag to see related articles)

Publish this Article on your Website, Blog or Newsletter

This article is available for publishing on websites, blogs, and newsletters. The article must be published in its entirety - all links must be active. If you would like to publish this article, please contact us and let us know where you will be publishing it. The easiest way to get the text of the article is to highlight and copy. Or use your browser's "View Source" option to capture the HTML formatted code.

If you would like a specific article written on a medical coding and billing topic, please Contact Us.


innoviHealth Systems, Inc.
62 East 300 North
Spanish Fork, UT 84660
Phone: 801-770-4203 (9-5 Mountain)
free demo
request yours today
for any budget
sign IN
welcome back!

Thank you for choosing Find-A-Code, please Sign In to remove ads.