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Wiki well womaen exam billing

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WendySPeters

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my provider and I are having a discussion ;) on the Pap Smear code for Commercial Plans. She states it is the G0101 however, we are being denied as not coded correctly. I think it is 88142.

What is the general code for a commercial plan female who is 30 yrs old and gets a pap smear??
 
I know that G0101 is not intended for commercial use, I had 2 claims I used as a "test" for her but now Im confused on the numerous codes in the CPT which one to use for Commercial plans.
 
88142 is a lab code, unless you are performing the lab you do not use this code. If you are performing a well woman you use the V72.31 with the preventive E&M OR the G0101. It does depend on the payer. G0101 is not strictly Medicare it is a payer discretion use code. There is no CPT code for a PAP smear collection by the provider it is simply part of the visit. If this is not a well visit then you just bill the E&M, performing the pelvic and collection of the PAP is just an element of exam.
 
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