Results 1 to 2 of 2

Diagnosis Codes for Annual, Pap smear, hysterectomy, hx cancer

  1. Default Diagnosis Codes for Annual, Pap smear, hysterectomy, hx cancer
    New Call-to-action
    Which diagnosis codes do you use for Preventative GYN visit 993xx and 88175 Pap smear, patient has had a hysterectomy due to endometrial cancer and vag Pap is done. Would Z01.419, Z90.710, Z85.42 be correct?

    Would the same diagnosis codes used for this for both commercial insurance or Medicare?

  2. #2
    Default
    For all insurance except Medicare, I use the routine preventive 99381-99397. I use diagnosis Z01.419 mostly, with the occasional Z01.411. Z00.00 is required for Medicaid. They will deny Z01.419. For Medicare, I use G0101 and Q0091 with Z01.419, Z12.4 or Z01.411, unless they are high risk.

    Medicare covered codes for low risk: Z01.411, Z01.419, Z12.4, Z12.72, Z12.79, and Z12.80
    Medicare covered codes for high risk: Z77.22, Z77.9, Z91.89, Z72.89, Z72.51, Z72.52, and Z72.53.

    I find that if Z72.51 is the only code, Medicare has been denying 88175 for dx not covered.

    Since the patient is s/p hysterectomy, I would use the diagnosis for encounter for screening for malignant neoplasm of vagina, with a secondary code for acquired absence of both uterus and cervix (if that's what was removed. There are other codes for partial absence, etc.)

Similar Threads

  1. Coding an annual wellness exam for Medicare patient and the Pap smear
    By debimig317 in forum Medicare Regulations
    Replies: 2
    Last Post: 03-15-2016, 09:17 AM
  2. Replies: 2
    Last Post: 08-14-2014, 06:39 PM
  3. Pap smear for a Medicare patient who had a hysterectomy for uterine cancer
    By debdunning in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 10-22-2010, 02:27 PM
  4. Annual Pe with a pap smear
    By cnramsey in forum Medical Coding General Discussion
    Replies: 1
    Last Post: 06-21-2010, 04:57 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.