Okay, this is not my area, so you can take what I have to say about this with a big ol' grain of salt.

For Q0091: I understood the obtaining of a pap smear to be included in the preventive service of a well woman exam. Medicare has a separate code for the service BECAUSE they don't cover well woman exams, but they will cover the obtaining of the pap (as long as it is within their specs) during the well woman exam.

All of the references I have been able to find support this, and I have been able to find nothing to the contrary.

Regarding the ultrasounds: Do your diagnoses support the medical necessity of doing a transvag u/s AND a complete non-obstet u/s? Are there two separate reports? Just some things to think about.

Regarding the blood draws: Have you checked your contract and provider handbook (which is often incorporated into the contract) to see if they provide separate reimbursement for this? It is OFTEN not a covered service. You can always send your patients directly to a lab for blood draws unless you have a lab inhouse.

Sharon