tci Medicare Compliance & Reimbursement - 2023 Issue Q2

Part B Coding Coach: OB-GYN: Pocket This Primer on Preventive Services

Find out how to use Medicare’s ‘carve out’ rule. If providing preventive ob-gyn care for your Medicare patient has you stumped, you’re not alone. Coding and reporting these visits can be confusing — and appending the right modifier is essential. Context: Suppose a Medicare patient comes into your ob-gyn practice for a preventive service that does not meet the definition or timing requirements of HCPCS code G0101 (Cervical or vaginal cancer screening; pelvic and clinical breast examination) as well as an evaluation and management (E/M) service at the same visit. Do you know how to calculate...

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