Ob-Gyn Coding Alert

Question: I have a question regarding new pregnant patients: I know to use the new code V72.42, but our ob-gyns frequently perform a Pap smear when the patient comes in. What diagnosis code should I link to that service? Could I use well-woman V72.31, or should I use V72.42 to get paid for the service?


Virginia Subscriber


Answer: The Pap smear is not related to the pregnancy, so if your ob-gyn performs only the Pap smear, you provide the link (V76.2, Special screening for malignant neoplasms; cervix) to the lab that does the interpretation. Keep in mind: Carriers rarely pay separately for the Pap specimen collection on the first visit.
 
If your ob-gyn performs a separate and significant preventive annual exam at the time of this visit, you can use the preventive medicine codes (99381-99387 for a new patient, 99391-99397 for an established patient). You should link the diagnosis v72.31 (Routine gynecological examination) to the preventive E/M service.
 
Red flag: You must remember to separate V72.31 from the pregnancy diagnosis (such as V72.42, Pregnancy confirmed) and show that V72.31 relates only to an annual preventive exam.