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Pathology/Lab Coding Alert

READER QUESTIONS:

Distinguish Purpose for Pap Codes

Published on Thu May 04, 2006

Question: Is it true that P3000 and HCPCS G0123 are exclusively for Medicare? If so, what codes should I report for Pap smears for non-Medicare payers?


Delaware Subscriber
Answer: Although most non-Medicare payers won't accept HCPCS Level II codes such as P3000 and G0123 for Pap smears, you should not necessarily always use these codes for Medicare.

Only use the HCPCS Level II codes to report screening Pap tests for Medicare patients, that is, tests ordered when the patient has no signs or symptoms of disease. Use the CPT Pap codes for other payers and for diagnostic Pap tests for Medicare patients. Physicians order diagnostic tests when the patient has a symptom that requires diagnosis.

You also have to choose the appropriate Pap test code based on the method that your lab uses to perform the test. The following table shows some pairs of Pap test codes that have similar definitions for HCPCS Level II and CPT codes:
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