Wiki Medicare screening paps that require physician interpretation.

[bbooks]

Is it appropriate to use 88141 for physician interpretation of Medicare screening pap smears?

Example: a lab tests a screening pap smear uses G0145. The pap requires interpretation by a physician. Medicare states that the proper code for the interpretation is G0124, and using the screening V-code as the primary ICD-9 code with the pathological diagnosis as a secondary ICD-9 code.

An argument is made that since the pap is abnormal, it has now become a diagnostic pap and therefore could instead be coded with 88141 and using just the pathological diagnosis for ICD-9, omitting the screening V-codes.

Comments?

 

[ColqPath]

To determine whether to bill a pap smear on a Medicare patient as a routine screening or diagnostic pap is according to the clinical history or symptoms present when the specimen is sampled (e.g. attending physician sends pap as routine with no additional history then it would be considered routine regardless of the findings by the cytotechnologist and/or pathologist; another example could be the clinical history indicates postmenopausal bleeding which would indicate a diagnostic pap, again regardless of the findings). Medicare only allows certain diagnosis codes for diagnostic pap smears and V15.89 is accepted by Medicare for patients who are at high risk and require more than one routine pap smear every three years. Getting accurate clinical information with the pap smear request is so important. A rule of thumb to remember is G codes are billed with V codes and CPT codes with ICD 9 codes. Hope this helps a little.

 

[bbooks]

Thanks so much for your feedback. Your comments help me confirm that it is not appropriate to use 88141 on all Medicare pap physician interpretations.