Pathology/Lab Coding Alert

Question: We're having problems with denials when we bill Medicare for a thin-prep screening Pap (G0145) along with the physician review (P3001) if the automated screening/tech rescreening identifies an abnormality. We're billing the codes with diagnosis V76.2. We've tried using modifier 59 to no avail -- how should we bill these cases? Indiana Subscriber Answer: You are correct to bill a screening thin-prep Pap with automated screening and manual rescreening for a Medicare patient using G0145 (Screening cytopathology, cervical or vaginal [any reporting system], collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision). The problem appears to be your code choice for physician review when you detect an abnormality -- P3001 (Screening Papanicolaou smear, cervical or vaginal, up to three smears, requiring interpretation by physician). You should report P3001 only if your lab performs the initial Pap screening using a method [...]