tci Part B Insider - 2003 Issue 14

Coding: When Routine Ob-Gyn Screenings Turn Up Problems

Use These Strategies to Avoid Double-Billing, UpcodingWhen a patient comes in for a routine annual or biannual Pap smear and pelvic exam, other problems may arise. But when should you bill for those added claims? With a non-Medicare claim, there's a simple rule of thumb: If more than 50 percent of a visit is taken up with an annual exam, just bill for the annual exam, says Philip Eskew, medical director for women and infant services with St. Vincent Hospital in Indianapolis. But since Medicare only pays for a breast exam, Pap smear and pelvic exam, not...

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