Q0091 is for “obtaining the screening Pap”. If you are doing a woman’s annual “high-risk” pap, you can use this code to obtain it. If it were a diagnostic pap, this code would not apply. And, if the physician is NOT doing the pelvic exam (G0101) annually for a high-risk patient, he is throwing money out the window, IMHO.
Medicare allows for a pelvic exam and screening pap every two years; however, if the patient is “high-risk” they are allowed to get a screening pap every 12 months. High-Risk Factors are:
Cervical Cancer High Risk Factors
* Early onset of sexual activity (under 16 years of age) * Multiple sexual partners (five or more in a lifetime) * Sexual partners who have multiple sexual partners * History of a sexually transmitted disease (including HIV infection) * Fewer than three negative Pap tests within the previous seven years
Vaginal Cancer High Risk Factors
* DES – exposed daughters of women who received DES during pregnancy * Women (under age 65) who have not had a Pap test in 5 years or more.