Ob-Gyn Coding Alert

Question: Does 99396 include 88150 and 81000, or can I separate these services?

Michigan Subscriber

Answer: First of all, you would not be billing 88150 (Cytopathology, slides, cervical or vaginal; manual screening under physician supervision) because you are not a laboratory billing for the  pathology service, so cross that off your list.

You say that you're reporting 99396 (Periodic comprehensive preventive medicine re-evaluation and management of an individual including an age- and gender- appropriate history... established patient;40-64 years). The collection of the Pap specimen is included as part of the preventive service by mostpayers (except Medicare who will allow you to bill Q0091 [Screening Papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory] in the covered year, and some private payers).

Code 81000 (Urinalysis, by dipstick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, with microscopy) is the urinalysis (UA). Payers may deny this if your ob-gyn does this just for routine screening on all patients. CPT rules allow you to code this separately.