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papsmears

  1. Default papsmears
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    Anthem BSBS requesting to add a modifier when coding a pap, 88142 and that is a recent request by ANTHEM, otherwise they will consider the pap inclusive to the Office visit. Does anyone know what type of modifier I need to add.? Thanks in advance

  2. #2
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    Columbia, MO
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    88142 is not a code for the OB physician to use to do the pap. This code is used at the lab.

    Debra A. Mitchell, MSPH, CPC-H

  3. Default
    Quote Originally Posted by hbsg11 View Post
    Anthem BSBS requesting to add a modifier when coding a pap, 88142 and that is a recent request by ANTHEM, otherwise they will consider the pap inclusive to the Office visit. Does anyone know what type of modifier I need to add.? Thanks in advance
    Oops, you are right, I'm coding an annual visit and an outside lab, does that mean when coding the annual visit I need to add the modifier or do I include the modifier on the 88142?

  4. #4
    Location
    Columbia, MO
    Posts
    12,557
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    So you are paying the lab a fee and then billing the code for the lab?

    Debra A. Mitchell, MSPH, CPC-H

  5. Default modifier for papsmear
    The way I'm billing it is as follows:
    CPT 99395 (annual visit)
    99000 lab handling
    88142 pap

    I'm not sure then what type of modifier does anthem need ?

    Thanks Mitchell for your quick assistance...

  6. #6
    Location
    Columbia, MO
    Posts
    12,557
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    If you are sending the specimen to the outside lab and thy are not doing their billing, you are paying them and you are then billing the labs then you need to fill in the field on the 1500 for the outside labs and you may need a 90 modifier. If you are not paying the lab, as they submit their own claims, then you cannot bill the 88142 at all.

    Debra A. Mitchell, MSPH, CPC-H

  7. Default
    [COLOR="Green"[/COLOR]
    Just a quick answer Debra to thank u vm for your help.
    Could not answer u earlier, GI buck....feeling way better now...
    THANKS

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