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Billing for Pap Only

  1. #1
    Default Billing for Pap Only
    Medical Coding Books
    Does anyone have any suggestions on how to bill for a routine pap only? I work in peds and a lot of the teen girls prefer to see our female doc for just the pap when the male doc has done the rest of the PE. Of course these are done on different DOS. Don't want to bill with the PE cpt's as only one a year usually gets covered. Can I bill dx V72.31 with an ov e/m?? Any thoughts?? Thank you in advanced!!

    Ellen Risotti, cpc in training!!

  2. #2
    Default
    I would try V76.2.

  3. #3
    Location
    San Gabriel Valley
    Posts
    31
    Default pap only
    Check your carriers 1st but you could code
    Q0091 V76.2 Screening cervix
    Or the preventive code with mod 52 reduced services with V76.2.

    Again refer to your insurance contracts.
    Rebecca Lopez CPC

  4. #4
    Default
    Quote Originally Posted by stampinriz View Post
    Does anyone have any suggestions on how to bill for a routine pap only? I work in peds and a lot of the teen girls prefer to see our female doc for just the pap when the male doc has done the rest of the PE. Of course these are done on different DOS. Don't want to bill with the PE cpt's as only one a year usually gets covered. Can I bill dx V72.31 with an ov e/m?? Any thoughts?? Thank you in advanced!!

    Ellen Risotti, cpc in training!!
    At our practice we bill it with the Q0091 and v72.31. Unless it's one of the blues and then we bill the s0612 w/ v72.31

    Roxanne Thames, CPC

  5. #5
    Location
    Seacoast- Dover New Hampshire
    Posts
    609
    Default
    Do the Blues pay for the S code?
    Karen Barron, CPC
    Hampton New Hampshire Chapter

  6. #6
    Default
    Hi,

    I remember reading a really in-depth article on the aafp website stating that a preventive code with a (-52) modifier when only a portion of the visit was done, i.e. only the pap.

    The article did also make mention of the Q code.

    Check out their website/article archives.

    Good Luck!
    Sylvia Thompson, CPC
    Billing Supervisor
    San Diego, CA

  7. #7
    Default
    Quote Originally Posted by kbarron View Post
    Do the Blues pay for the S code?
    Yes they do pay for the S code.

    Roxanne Thames, CPC

  8. #8
    Default S codes for Annual GYN exams

    We use the S codes for BC of NEPA/FPH/FPLIC too in PA.

    Does anyone know of any other carriers that are using the S codes?

  9. Default
    my opinion is that the pap is considered to be part of another service rendered at the same encounter (e.g., a screening Pap smear done in conjunction with a preventive medicine visit or a diagnostic Pap smear done at a problem-oriented visit). If the specimen is sent to an outside laboratory, CPT code 99000, can be used for handling the specimen. A lot of times this is considered inclusive, but unless you are a laboratory this is the only code that I have found that qualifies for the collection of the smear, if your physician documents an e/m you can bill that as well I would use the V76.2 diagnosis code.

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