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Pap Smear Coding

  1. #1
    Default Pap Smear Coding
    Medical Coding Books
    We know these are usually not paid seperately when doing a preventative service however we are confused about correct coding for the office.
    99395 E&M
    88142 Pap Smear
    99000 Specimen Handling
    Is this correct?
    Thanks we are so confused!
    Jan

  2. #2
    Location
    Greeley, Colorado
    Posts
    2,045
    Default
    Why would you code 88142 in the office AND 99000?

  3. #3
    Default
    That is why we are asking for the proper coding. How would you do it?

  4. #4
    Location
    Seacoast- Dover New Hampshire
    Posts
    609
    Default Ppp Smears
    I think that 88142 is for a lab charge not a Dr charge.
    Karen Barron, CPC
    Hampton New Hampshire Chapter

  5. #5
    Default
    You wouldn't bill 88142 as that is for the lab....it is very confusing though, i agree!
    Dawnelle Beall, CPC, CPMA, CPC-I
    Licensed AAPC PMCC Instructor
    AAPC ICD-10CM Certified Trainer
    Previous AAPC Local Chapter President & VP

  6. #6
    Smile
    88142 can not be billed by a physican office; only by the laboratory where the specimen was submitted for testing.

    A few carriers may still reimburse 99000 but most do not. The reason being is that the laboratories tend to provide offices with the supplies (and requisition forms) at no charge and generally have a courier pick up the specimens at no charge. Since you are not charged for supplies or pick up, you should not bill (or expect reimbursement) for 99000.
    Susan M. Garrett, CPC, COC
    Past President El Paso Texas Chapter AAPC
    Past Member AAPCCA Board of Directors
    cell 915-204-8333

  7. Default pap smear coding
    what i would use for the diagnosis is V72.32 and for the pap Q0091 for the office portion. If the do wet mounts or KOH those can be coded if done and interpreted in the clinic

  8. #8
    Location
    Spokane, WA
    Posts
    20
    Default
    Hi Jan,
    For regular annual pap, we use v72.31 as primary dx, 99394-99397 (age appropriate E/M) and either Q0091 or 88150 for the pap (88150 is a CLIA waived test and may be reported if performed in the clinic with QW modifier since this is a manual screen done by provider). Some payors accept Q0091 and others accept the 88150 so you would need to call your carriers for clarification. CMS accepts G0123, G0124, G0141, G0143, G0144, G0145, G0147, G0148 and Q0091. Annually, if high risk or every 24 months for all other if pt is Medicare/Medicaid. You will need to get with your providers and go over these codes to obtain clarification of which one fits best for your office procedures being performed.
    ScottShar

  9. #9
    Default
    I'm new to this speciality so can you clarify for me if you bill 99387, G0101,
    Q0091 and when? 99387 w/ a problem?? and G0101 for annual?? for medicare pts for medicare pts. what code do you use for the pap for primary insurances?
    adrianne, cpc

  10. #10
    Location
    St. Cloud, MN
    Posts
    58
    Default
    I am new to this specialty as well and I am struggling with papsmears as well. It looks like we are getting reimbursed for the H&P and not at all for any collection, conveyance or any of the papsmear and pelvic exam, just the H&P only. Is this correct? If medicare pays for it, why can the others not?

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