Wiki Coding Abnormal Pap

[jlund1]

I work for a Family Care Clinic, and my team and I have a question about coding abnormal paps: For exaple

Pt came in on 01/09/2009 to get a pap done (this is not a PX). The physicain put "abnormal pap" down for a DX. The pt's pap results came back normal, but thier pap from the previous year (01/04/2008) came back abnormal.

Now, how would we code this? Can we use the 795.0X for the visit becasue the pap was abnormal before? Or since on that visit the pap was normal, we would have to use a screening code?

Please help!!!

Thanks- Jessica

 

[dmaec]

I'd code the 795.0X... it's the reason she was having another one (albeit almost a year had gone by)... BUT this current one, was "negative" AFTER the fact. So, because she had an abnormal pap before, it's why she was having another now, and thankfully - back to normal

 

[mcabanzon]

if the pap smear was abnormal a year ago, the dx for this year can't be abnormal. Is the patient doing the pap smear this year as a screening test, then you need to code a screening dx. Insurance will cover a pap smear every year.

 

[debi7478]

Abnormal pap

I code those by what the pathology report said on the previous pap or if you do not have that information then use V72.32 if this pap is normal. Also we use the 99213 code for these repeat paps.

 

[dmaec]

insurance does cover pap's every year (not Medicare UNLESS they're high risk)... and, if they're last pap was abnormal, and that's "why" they are having another pap done ...NOT as a typical annual screening - then, yes - you can and should code the abnormal pap code. IF however this was just a typical annual screening (which insn't how I read the original post)...then yes, you'd code the screening pap code... and again, my insurance covers my annual (that's YEARLY) pap test.

that being said, "typically" when a person has an abnormal pap, they don't wait a year before having another - they usually have one 3-6 months later. and again at one year.. AND, usually you have to have 3 "normal" pap smears after and abnormal pap to be back on track of "regular" annual screening paps...

at least this is how it is where I'm at