Help: FAQs, tutorials, videos, page index and more
Viewing:  Sep 21, 2019

Preventive Services: Screening Pelvic Examinations

By:  Find-A-Code
Published:  September 1st, 2017

The following information from the Medicare Learning Network provides guidance from the Department of Health and Human Services on Screening Pelvic Examinations (includes a clinical breast examination): 

HCPCS/CPT Codes

G0101 - Cervical or vaginal cancer screening; pelvic and clinical breast examination

ICD-10 Codes

High risk – Z77.29, Z77.9, Z91.89, Z92.89, Z72.51, Z72.52, and Z72.53

Low risk – Z01.411, Z01.419, Z12.4, Z12.72, Z12.79, and Z12.89

Current codes are listed in the ICD-10 Conversion/Coding Infrastructure Revisions to National Coverage Determinations (NCDs)--3rd Maintenance CR9252. The Medicare Claims Processing Manual, Chapter 18, Section 40.4 is pending an update to correct this information.

Who Is Covered

All female Medicare beneficiaries

Frequency

  • Annually if at high risk for developing cervical or vaginal cancer or childbearing age with abnormal Pap test within past 3 years
  • Every 2 years for women at normal risk

Medicare Beneficiary Pays

  • Copayment/coinsurance waived
  • Deductible waived

Please note: The information in this educational product applies only to the Medicare Fee-For-Service Program (also known as Original Medicare). For additional guidance on using diagnosis codes, go to the Medicare Claims Processing Manual, Chapter 18 on the Centers for Medicare & Medicaid Services (CMS) website.

Watch the CMS Provider Minute: Preventive Services video for pointers to help you submit sufficient documentation when billing for certain preventive services.


References:

###

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.


Our contact information

Find A Code, LLC
62 East 300 North
Spanish Fork, UT 84660
Phone: 801-770-4203 (9-5 Mountain)
Fax: 801-770-4428
Email:
Free 14 Day Trial
No Credit Card Required
Pricing
Starting at $10/month
Sign In
Welcome back!