Wiki Medicare Annual Exam

Hello,
I did find a very nice write up of how to bill for a Medicare GYN annual exam, but I have a question.
I was trained by our last coder to enter a special code they created, 99214, M for Medicare annuals. This charged them the annual fee of $238, I believe. I have never entered the G0101 or the Q0091.
I want to be doing this correct so I am looking into it further.
Our Medicare patients come in for "health maintenance exam." Typically they do not need a pap, they usually always get a pelvic exam and breast exam. Blood pressure, weight and general exam done. A lot of times they have had a hysterectomy, usually for benign reasons.
What should I be entering for something straight forward like this?
Thank you for your time!

If no problems are being addressed, and patient is receiving a cervical/breast cancer screening, then G0101 would be appropriate. If they do require a PAP, then also Q0091. If a full preventive visit is performed, then 9938x-9939x are appropriate. Remember that G0101 & Q0091 are covered every 2 years for most patients, or annual if documented high risk. Preventive 9938x-9939x are not covered at all by Medicare and patient may be billed.
If the provider is addressing and treating problems in addition to the above (menopause symptoms, vaginal discharge, breast lump, etc), then 99202-99215. Modifiers may be required.

While a Medicare ABN is not required for preventive care that is statutorily excluded, it is a really good idea to help explain to patients why and what they are being charged for.

I'm not clear with your "special code" of 99214,M whether that is being billed to insurance, or to the patient? Regardless, if it was not a problem oriented visit (or did not meet moderate MDM or time requirements), then it is not be correct.

My guess is at some point, someone at the practice tried to streamline the process, but may not have factored all the coding nuances that could be occurring.