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Billing preventive gynecological visits for Medicare Advantage members

March 31, 2016

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When billing preventive gynecological visits for Medicare Advantage members, providers must report the specific Healthcare Common Procedure Coding System (HCPCS) codes that represent the annual gynecological examination for new or established patients. Providers should discontinue using Annual Wellness Examination procedure codes to report annual gynecological exams.

For the specific HCPCS codes, please review Attachment B within policy #MA00.003c: Preventive Care Services on our Medical Policy Portal. Select Accept and Go to Medical Policy Online, then select the Medicare Advantage tab from the top of the page and type the policy name or number in the Search field.

You can also get to our Medical Policy Portal through the NaviNet® web portal by selecting the Reference Tools transaction, then Medical Policy.

NaviNet is a registered trademark of NaviNet, Inc., an independent company.

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