Wiki need help on pap smear coding

[jbhuju]

hello,
can outpatient physician bill pap smear cpt codes ( 88141-88177) with appropriate E7M codes? or these code can only be billed by labs not physician. please help. i am getting really confuse on this because most of our provider use this code and insurance is denying due to invalid POS.
please help.

 

[njycarter17]

hello,
can outpatient physician bill pap smear cpt codes ( 88141-88177) with appropriate E7M codes? or these code can only be billed by labs not physician. please help. i am getting really confuse on this because most of our provider use this code and insurance is denying due to invalid POS.
please help.

When we bill for PAP smears we just bill 9939X/9938X with dx Z01.419 for commercial insurances and G0101 (pelvic and breast exam) and/or Q0091 (PAP Smear) with dx Z01.419 for Medicare insurance since our providers sent the PAP smear to the lab - the lab will bill the 88141-88177.

 

[lgardner]

When we bill for PAP smears we just bill 9939X/9938X with dx Z01.419 for commercial insurances and G0101 (pelvic and breast exam) and/or Q0091 (PAP Smear) with dx Z01.419 for Medicare insurance since our providers sent the PAP smear to the lab - the lab will bill the 88141-88177.

the screening dx code for a cervical pap smear is Z12.4.
Z01.419 would be used for a well woman exam, not the pap.

 

[OpenClaims]

If The Pap was done in the office then you can code Z12.4 if you are coding a health maintenance exam, but if you're coding a Gynecological exam you cannot code the Z12.4 with it because those two ICD 10 codes are non-compatible together. The lab will code for the actual Pap smear laboratory code. If the patient has Medicare you can code G0101 and Q0091. Keep in mind that you can only code G0101 if the patient exam has met the seven factors to qualify for this code.