Wiki repeat Pap smear

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jbhuju

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hello all,

i have a question regarding on repeat pap smear. do we charge E&M code with repeat pap smear? patien had done firat pap smear with other provider and came back to clinic after few months for repeat pap smear with different provider. so how do we bill please help.

thank you
 
It's appropriate to charge E&M if an E&M was medically necessary and performed. It would likely be a low level visit.
 
csperoni said:
It's appropriate to charge E&M if an E&M was medically necessary and performed. It would likely be a low level visit.
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thank you so much for help :)
and do i need to charge pap smear cpt with modifier too or just low level E & M code would be fine?
 
Are you doing the lab portion of analyzing the PAP? If so, I believe that would be billable, but have no experience in the lab portion.
If you mean Q0091 for obtaining PAP, I believe it's not appropriate as this is diagnostic, not screening when you are repeating an abnormal PAP.
Q0091 Screening Papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory
 
csperoni said:
Are you doing the lab portion of analyzing the PAP? If so, I believe that would be billable, but have no experience in the lab portion.
If you mean Q0091 for obtaining PAP, I believe it's not appropriate as this is diagnostic, not screening when you are repeating an abnormal PAP.
Q0091 Screening Papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory
Click to expand...
we did office visit with 88164 few months back and now doing repeat pap smear for inadequate sample. so in this case do we just bill low level E&M code or just bill 88164.
thank you so much for help :)
 
Around my parts, I never heard of any physician actually interpreting the PAPs - it is going to a laboratory and interpreted by a pathologist.
If 88164 describes what was done to interpret the PAP, I do not believe it's wrong to bill it a second time as the pathologist or lab tech is actually preparing and analyzing a slide a second time.
Regarding E&M code for inadequate sample, you have to decide whether you feel it's appropriate to bill an additional E&M. My personal opinion is that if ANYTHING else were done, then go ahead and bill E&M. But if the physician already knew what was going to be done, just obtained the specimen without any additional history, exam or MDM, then I would not bill for it. If we have a patient return just to obtain another specimen, we do not bill for it, but it's usually within 2 weeks. Since this was months later, if clinician is evaluating anything else, renewing a med, etc, then go ahead and bill your E&M.
 
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