Pathology/Lab Coding Alert

To report liquid cytology Pap tests properly, you have to know not only how the lab conducts the test but also why the lab conducts the test. You should report thin-layer preparation Pap tests ordered for screening purposes with a different set of codes than those ordered for diagnostic purposes. Screening Thin-Layer Preparation Pap Test Codes:

"Use these HCPCS Level II codes when the physician orders a liquid cytology Pap test in the absence of signs or symptoms of disease," says Elizabeth Sheppard, HT (ASCP), manager of Anatomic Pathology at Wake Forest University Baptist Medical Center in Winston Salem, N.C.:

G0123 Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin-layer preparation, screening by cytotech-nologist under physician supervision G0143 Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin-layer preparation, with manual screening and rescreening by cytotechnologist under physician supervision G0144 Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin-layer preparation, with manual screening and computer-assisted rescreening by cytotechnologist under physician supervision G0145 Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin-layer preparation, with manual screening and computer-assisted rescreening using cell selection and review under physician supervision.   Diagnostic Thin-Layer Preparation Pap Test Codes:

"Only use these liquid cytology CPT codes when the physician orders the Pap test based on presenting signs or symptoms of disease, including previous abnormal Pap," Sheppard says:
88142 Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin-layer preparation; manual screening under physician supervision 88143 with manual screening and rescreening under physician supervision 88144 with manual screening and computer-assisted rescreening under physician supervision 88145 with manual screening and computer-assisted rescreening using cell selection and review under physician supervision.