Screening vs Diagnostic Pap

SWsibemom

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If a client sends the lab a requisition for a screening pap and the pathology report states it is an abnormal pap, would we code it as screening with the diagnostic Dx’s as secondary or would you place the diagnostic Dx’s first with the screening last?

Also, would we convert it to the diagnostic CPT code?

I appreciate any insight anyone can provide as I would like to get everyone to code them correctly.
 
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pookergirl

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I code alot of paps - if patient has a screening pap (Z12.4 usually) then screening Dx always gets coded first (admitting and primary). Any abnormal findings after the path is interpreted goes as a secondary Dx. The CPT charge should stay screening.
 

SWsibemom

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I code alot of paps - if patient has a screening pap (Z12.4 usually) then screening Dx always gets coded first (admitting and primary). Any abnormal findings after the path is interpreted goes as a secondary Dx. The CPT charge should stay screening.
Thank you! I was reading that if it is ordered as a screening, we code it with the screening Dx listed first followed by any abnormal findings by the pathologist as secondary codes. It also stated to not change to the diagnostic CPT code. I appreciate your confirmation on the correct way to code these.
 

mitchellde

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I am not sure what you are looking at but there is no CPT code for a diagnostic PAP. For the collection of the specimen. There is a Q0091 for a screening PAP. Are you coding for the GYN or the Pathologist, or the lab?
 

SWsibemom

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I am not sure what you are looking at but there is no CPT code for a diagnostic PAP. For the collection of the specimen. There is a Q0091 for a screening PAP. Are you coding for the GYN or the Pathologist, or the lab?
We are a lab coding for the Pathologist.
 

mitchellde

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you are looking at the 88141-88175 codes to report the lab charges. These codes are the same whether it is screening or diagnostic. The diagnosis will be different if it was screening vs diagnosis. So I am confused when you state
. It also stated to not change to the diagnostic CPT code.
What codes are you using for the charges?
 

SWsibemom

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To clarify we code for lab and pathology. We use CPT codes 88141-88175. We also use P3000, G0145, G0148 for screening (when applicable).

I am trying to clarify:
1. When a client gives us a requisition for screening pap but the pathologist reports there is an abnormality, would we code the screening as first listed with the abnormality as secondary Dx.
2. When the pathologist finds an abnormality for the screening pap, do we then change it to the CPT codes rather than the P and G codes or do we keep it as a screening since that was the original intent?

My understanding is that we stay with the original intent of screening for Dx sequencing with screening first followed by the abnormalities found.
My understanding for procedure coding is that we would not change the P and G (screening) code to a CPT code because again the original intent was screening so we don't change from screening just because there was an abnormality found.

Is my understanding correct?
 
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mitchellde

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Apologies, your question much more clear now, and yes you are correct you would keep the screening P or G codes for those payers that use them and keep the screening diagnosis code first listed add the finding as a secondary diagnosis code.
 

SWsibemom

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Apologies, your question much more clear now, and yes you are correct you would keep the screening P or G codes for those payers that use them and keep the screening diagnosis code first listed add the finding as a secondary diagnosis code.
Thank you for your confirmation of the correct way to code paps for pathology. Much appreciated.
 
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