ICD code for "negative" pap smears

Lcubed

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Hello all!

I am wondering if anyone can offer guidance for ICD code entry for the 88141 pap smear interpretation? :confused:
The situation is this: We have a pap smear that is a screening code order = Z01.419 and the cytotechnologist moves the pap smear to the pathologist queue for review of (abnormal?) cells. The pathologist has a negative interpretation - the cells are normal so they (usually) enter a "negative" code = Z12.4. I know that this is an "Excludes 1" note and to be honest we have never had a problem until this week. So I am having that corrected.
However, what code should the pathologist be using in this situation? They were "told to enter a second code ICD after the ordering ICD" and so they enter Z12.4.
Do they really need (2) codes? If so, wouldn't they just use the Ordering code since this is a negative pathology? So they really DON'T need 2 codes.

Any help is appreciated.

Thank you!
Laura
 

danachock

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88141 negative pap smear

Hi Lcubed;
If the 88141 pathologist interpretation was normal you would simply code it with whatever code or code(s) were provided on why the testing was actually being done (documented proof). Someone (provider had to provide an order and diagnosis before this testing was completed.) If not ~ not billable.
Thanks,
Dana Chock, RHIT, CPC, CANPC, CHONC, CPMA, CPB
 
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