• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below.
  • We're introducing new features and a new look to make the forums easier to use and more valuable to you. See what's new and let us know what you think!

Repeat inadequate pap


Best answers
Would anyone be willing to let me know their thoughts on pathology billing for repeat screening paps due to inadequate cells the first time? I'm new to Pathology and had this come up a few times lately. I can't find any official rules, just wondering how others handle it:

V code as primary and 795.08 as a secondary on the first service?

V code again or 795.08 as primary for the second service?

Modifier 76??. Does insurance cover both services??

Any suggestions would be appreciated.
New Orleans, LA
Best answers
I don't have my books handy but since no one else is stepping up, 795.08 should be the only dx and there shouldn't be a need for a modifier for a single test on its own DOS. Insurers may differ but this code set should adequately describe the service being performed without any need for additional information. It isn't necessarily a screening anymore if the initial test didn't yield a determinative interpretation. Nor is it technically a repeat test if the initial didn't yield a determinative interp. It stands alone and is ordered because of 795.08 which should be covered because it is self-explanatory.