Billing for Pap Only

stampinriz

Networker
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Does anyone have any suggestions on how to bill for a routine pap only? I work in peds and a lot of the teen girls prefer to see our female doc for just the pap when the male doc has done the rest of the PE. Of course these are done on different DOS. Don't want to bill with the PE cpt's as only one a year usually gets covered. Can I bill dx V72.31 with an ov e/m?? Any thoughts?? Thank you in advanced!!

Ellen Risotti, cpc in training!!
 

rebecca lopez

Networker
Local Chapter Officer
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San Gabriel Valley
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pap only

Check your carriers 1st but you could code
Q0091 V76.2 Screening cervix
Or the preventive code with mod 52 reduced services with V76.2.

Again refer to your insurance contracts.
Rebecca Lopez CPC
 

rthames052006

True Blue
Local Chapter Officer
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1,905
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York, Pa
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Does anyone have any suggestions on how to bill for a routine pap only? I work in peds and a lot of the teen girls prefer to see our female doc for just the pap when the male doc has done the rest of the PE. Of course these are done on different DOS. Don't want to bill with the PE cpt's as only one a year usually gets covered. Can I bill dx V72.31 with an ov e/m?? Any thoughts?? Thank you in advanced!!

Ellen Risotti, cpc in training!!
At our practice we bill it with the Q0091 and v72.31. Unless it's one of the blues and then we bill the s0612 w/ v72.31

Roxanne Thames, CPC
 
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San Diego
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Hi,

I remember reading a really in-depth article on the aafp website stating that a preventive code with a (-52) modifier when only a portion of the visit was done, i.e. only the pap.

The article did also make mention of the Q code.

Check out their website/article archives.

Good Luck!
 

heycodinglady

Networker
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31
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Danville, PA
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S codes for Annual GYN exams


We use the S codes for BC of NEPA/FPH/FPLIC too in PA.

Does anyone know of any other carriers that are using the S codes?
 

kellysarg21

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my opinion is that the pap is considered to be part of another service rendered at the same encounter (e.g., a screening Pap smear done in conjunction with a preventive medicine visit or a diagnostic Pap smear done at a problem-oriented visit). If the specimen is sent to an outside laboratory, CPT code 99000, can be used for handling the specimen. A lot of times this is considered inclusive, but unless you are a laboratory this is the only code that I have found that qualifies for the collection of the smear, if your physician documents an e/m you can bill that as well I would use the V76.2 diagnosis code.
 
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