Effective for services performed on or after June 20, 1994, payment will be made for one (1) annual gynecological examination (S0610 or S0612) regardless of the patient's condition, and one (1) routine pap smear (G0123, G0124, G0143-G0145, P3000, P3001) per calendar year for all females. A gynecological exam (code S0610 or S0612) may include, but is not limited to, the following services: history, blood pressure and/or weight checks, physical examination of pelvis/genitalia, rectum, thyroid, breasts, axillae, abdomen, lymph nodes, heart and lungs. When a physician performs a systemic physical examination which includes an annual gynecological examination, the appropriate evaluation and management code (99201-99215, 99381-99397) may be reported in addition to the annual gynecological examination (code S0610 or S0612).
Note: See Medical Policy Bulletin L-1 for additional information regarding pap smears. |