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Repeat inadequate pap

  1. Default Repeat inadequate pap
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    Would anyone be willing to let me know their thoughts on pathology billing for repeat screening paps due to inadequate cells the first time? I'm new to Pathology and had this come up a few times lately. I can't find any official rules, just wondering how others handle it:

    V code as primary and 795.08 as a secondary on the first service?

    V code again or 795.08 as primary for the second service?

    Modifier 76??. Does insurance cover both services??

    Any suggestions would be appreciated.

  2. #2
    I don't have my books handy but since no one else is stepping up, 795.08 should be the only dx and there shouldn't be a need for a modifier for a single test on its own DOS. Insurers may differ but this code set should adequately describe the service being performed without any need for additional information. It isn't necessarily a screening anymore if the initial test didn't yield a determinative interpretation. Nor is it technically a repeat test if the initial didn't yield a determinative interp. It stands alone and is ordered because of 795.08 which should be covered because it is self-explanatory.

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