Wiki Screening vs. diagnostic Pap


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Hi. I'm new to coding. An issue came up today in which a patient questioned our billing department about her pap. Since she had a wellness exam, her pap should not have been billed by our path lab as diagnostic. My job involves coding just the paps read by the pathologist: 88141.

Looking into the patient's history, we saw that she had a colpo and then a LEEP in 12/10, both of which showed 233.1. The patient did not return again for another exam until January of 2012. This pap was read by a pathologist as 795.09. I originally coded 88141 and 233.1 since the patient was still in a typical 2-year follow-up period for an abnormal pap, thus making this pap diagnostic. (My boss concurs with this.) I called the office that did the pap and they said that since she was due for her wellness exam, they considered this a screening pap. If this was the case, I would code V72.31 and 795.09.

Which is correct? Is the pap of January 2012 screening with the codes 88141, V72.31, 795.09 or diagnostic with the codes 88141, 233.1?

I work in a pathology office and code paps. We have to code with the ordering diagnosis first and the actual diagnosis second. If I don't have an ordering diagnosis or if I have a question on the diagnosis (ie routine pap V76.2 and 622.11 listed second) I fax the clinic and request clarification. It's either routine, high risk screening, or diagnostic and needs the correct diagnosis to go along with it.

hope that helps