Internal Medicine Coding Alert

Anytime a Medicare patient meets the risk and frequency requirements for a screening mammogram, Medicare will reimburse for the collection of a specimen, reported with code Q0091 (Screening Papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory). If the Medicare patient is considered "low risk" and receives her Pap smear biennially, link Q0091 to V76.2 (Special screening for malignant neoplasms; cervix); for Medicare patients considered "high risk" and receiving a Pap smear annually, link Q0091 to primary diagnosis code V15.89 and any secondary diagnosis codes that classify the patients as "high risk."

And if a separate E/M service is provided for a separate, significant problem, you can bill the E/M service separately if you append modifier -25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) to indicate that it is separate from the Pap.