The E/M code selected for a visit to collect a pap smear specimen should be based, of course, on the documentation in the record. Usually, if it's a simple re-pap, this will be a low level visit, and the ICD9 will usually be from the 795.xx series, unless it is a pap to confirm a recent normal pap following an earlier abnormal pap (eg ascus), in which case it's a V code....sorry, don't have it off the top of my head.
Keep in mind that collection of a pap specimen is included in the E/M code whether it is a problem visit or a screening exam, according to CPT. I hear that SOME payers other than medicare will pay for Q0091. If your payers DO pay Q0091, then it may not be appropriate to also bill an E/M if the visit, as you say, is just a simple, quick, repap.
Why would you be billing for the pap test itself? Doesn't the cytology lab bill for the actual processing and interpretation of the smear??
Patricia, CPC, COBGC