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Q0091 is for “obtaining th ...

Posted Nov 04 2009 10:05pm

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.

High Risk Diagnosis Code= V15.89

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