To make it more clear, if this was an annual exam, you would code with either Z01.411 or Z01.419 depending on whether the pap smear came back normal or abnormal. Therefore, you'd have to wait for the pap to come back before billing. Otherwise, you can code for whatever symptom the physician noted: vaginal discharge, pain, abnormality, or previous abnormal pap. Also there are screening codes that can be used, just depends on why he did the pap