CPT for PAP done by PCP

urbach34@yahoo.com

Networker
Messages
36
Best answers
0
Our billing manager is asking me to look up several CPT codes as she is updating our office charge slips. One of our PCP does PAPs in the office, so she has asked for the CPT code to add it to the slip. I am having a difficult time finding a clear explanation of how to code this. I have found Q0091 for Medicare, but I am uncertain how to bill to commercial insurance. Is there a code to use or is a PAP included in E/M? When billing to commerical, is the only way to indicate that a PAP was done through ICD10 code? If that is the case, what is the appropriate ICD10 to use?
 

stephanie.moore@wdhospital.com

Guru
Local Chapter Officer
Messages
195
Location
Seabrook, New Hampshire
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0
The pap is inclusive to the E/M or Preventative service (993xx). You are correct if it is a Medicare patient you bill the Q code. Here are a list of the codes that Medicare covers for PAPS: Z12.4, Z12.72, Z12.79, Z12.89, Z77.9 or Z91.89.
 
Messages
5
Location
Santa Barbara CA
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0
Check out the HCPC S0610-S0613, gyne codes. These codes were recommended to me by an Auditor. Some carriers pay $40 some pay $120. The Prevent codes 9938x-9939x should be for internal med utilizing for annual physicals for employment, school, etc.

Hope this helps!
CMR, CPCO, CPB
 
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