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New to OBGYN..need PAP help

  1. #1
    Default New to OBGYN..need PAP help
    Medical Coding Books
    Is it appropriate to code an EM along with the 88175 pap code, when the patient ONLY comes in for a pap, no other complaints or issues? There is some debate about billing it for the providers time, but I am not sure it meets the criteria of" above and beyond" or not

  2. #2
    The E/M code selected for a visit to collect a pap smear specimen should be based, of course, on the documentation in the record. Usually, if it's a simple re-pap, this will be a low level visit, and the ICD9 will usually be from the 795.xx series, unless it is a pap to confirm a recent normal pap following an earlier abnormal pap (eg ascus), in which case it's a V code....sorry, don't have it off the top of my head.

    Keep in mind that collection of a pap specimen is included in the E/M code whether it is a problem visit or a screening exam, according to CPT. I hear that SOME payers other than medicare will pay for Q0091. If your payers DO pay Q0091, then it may not be appropriate to also bill an E/M if the visit, as you say, is just a simple, quick, repap.

    Why would you be billing for the pap test itself? Doesn't the cytology lab bill for the actual processing and interpretation of the smear??
    Patricia, CPC, COBGC

  3. #3
    Seacoast- Dover New Hampshire
    When folks come in for a pap only, my docs give the 9939_ with Q0091. They also use V72.31. These are not always pd but our practices get rvu's. The 88175 is for the lab code only.
    Karen Barron, CPC
    Hampton New Hampshire Chapter

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