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Repeat Pap by Other Physician

  1. #1
    Location
    Daytona Beach
    Posts
    15
    Question Repeat Pap by Other Physician
    Medical Coding Books
    Can someone help with this? We have a Medicare patient who is having a repeat pap done within 6 months of previous pap that was done by other physician not affiliated with our practice. Reason for repeat was due to problem diagnosis by other physician.

    The Q0091 would not be appropriate w/76 modifier in this case. However, physician wants to charge for 214 level office visit and collection even if collection is not paid. Would the 88174 CPT be the correct code to use for collection?

  2. #2
    Location
    Greeley, Colorado
    Posts
    2,045
    Default
    I don't believe your doctor can code anything other than the E/M. 88174 is the pathology code, not to be reported by the provider obtaining the smear. The only time Q0091 would be reported is for a "screening" Medicare exam. I would advise your doctor to report the appropriate level E/M only.
    Lisa

  3. #3
    Location
    Daytona Beach
    Posts
    15
    Wink
    Quote Originally Posted by Lisa Curtis View Post
    I don't believe your doctor can code anything other than the E/M. 88174 is the pathology code, not to be reported by the provider obtaining the smear. The only time Q0091 would be reported is for a "screening" Medicare exam. I would advise your doctor to report the appropriate level E/M only.
    Lisa
    Thanks Lisa --
    This is what I thought, but wanted another professional coder's viewpoint.

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