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yearly physical plus pap

  1. #1
    Question yearly physical plus pap
    Medical Coding Books
    patient came in to see family phy. for yearly physical and also had a pap would it be coded as:

    99396
    v70.0 for physical

    and

    99000
    v76.2 or v72.31 for routine pap
    Last edited by kimb; 07-02-2008 at 04:34 PM.

  2. Default
    I was under the impression that Medicare has allowed the V72.31 to be the primary Dx on the Wellness CPT code, and so far our office has had no problems using this code as the primary dx with other payers.

    Christine

  3. #3
    Default
    I have yet to have an insurance company pay for code 99000
    Sincerely,

    Kristie Stokes, CPC, CPMA, CCS, CMDP, ICDCT-CM

    AAPCCA Board of Directors 2014-2017
    Region 1 - Northeast
    Maine, New Hampshire, Vermont, Massachusetts, Connecticut, Rhode Island, New York

    Today, give a stranger one of your smiles. It might be the only sunshine they see all day.

  4. #4
    Talking annual physical/pap
    how would you code a physical with a pap. patient was seen by family physician not by gyn. patient came in to have her yearly physical and also wanted the Physician to do her pap.

    99396 - v70.0

    99000 - v72.31 or v76.2
    Last edited by kimb; 07-03-2008 at 05:55 AM.

  5. #5
    Location
    Duluth, Minnesota
    Posts
    1,133
    Default
    if it's a medicare (not a welcome to medicare px) and routine pap/px I'd code:
    99396.GY- V70.0
    G0123 - V76.2
    Q0091 - V76.2

    Welcome to MC px IF all criteria is met and routine pap:
    G0344 -V70.0
    G0367 -V70.0
    G0638 -V70.0
    G0123 -V76.2
    Q0091 -V76.2

    Commercial Insurances:
    99396 - V70.0
    88142 - V76.2

    I've never used the 99000 UNLESS the specimen was actually transfered from say the clinic to an OUTSIDE facility lab.

    Donna

  6. #6
    Default
    Hey if your just coding a physical with a PaP smear.

    Just bill


    99385-99387 series
    or
    99395-99397 series

    depending if there new or est.

    And if your practice is just collecting and sending the pap smear out use
    Q0091 with V76.2.

    Example

    99385- V72.31
    Q0091- V76.2

    Regarding the G0123 or 88142.
    The G0123 looks like this only applies if your collecting the pap smear and reading the sample inhouse.
    And 88142 is what the pathologist use when you send out the pap smear to them. So becareful in some of the advice you receive regarding your question.

    Also the first scenario you posted is correct. But most PPO will not reimburse for the 99000 for the collection of a pap smear. Little trick to the trade. Thats why many coders picked up the Q0091.

    Respectfully
    Daniel
    CPC

  7. #7
    Default
    Quote Originally Posted by daniel View Post
    Hey if your just coding a physical with a PaP smear.

    Just bill


    99385-99387 series
    or
    99395-99397 series

    depending if there new or est.

    And if your practice is just collecting and sending the pap smear out use
    Q0091 with V76.2.

    Example

    99385- V72.31
    Q0091- V76.2

    Regarding the G0123 or 88142.
    The G0123 looks like this only applies if your collecting the pap smear and reading the sample inhouse.
    And 88142 is what the pathologist use when you send out the pap smear to them. So becareful in some of the advice you receive regarding your question.

    Also the first scenario you posted is correct. But most PPO will not reimburse for the 99000 for the collection of a pap smear. Little trick to the trade. Thats why many coders picked up the Q0091.

    Respectfully
    Daniel
    CPC
    Daniel,

    I agree with what your saying about the Q-code alot of payers are reimbursing for that and not only medicare. The office I work at now uses the S0612 for Blue shield Pap's ( not the specimen collection code).

    So for example if pt comes in for Physical and Pap ( I don't have my books at home but the 99385 87 code of 99395-97; and s0612 ( if it's blue shield or Cross).

    But I know where I used to work we used the q0091 for Blue cross and they paid it but was it coded correctly.... I can't say. It's something worth looking into.

    This topic is always a buzz. I"m hoping our coding committee can come up with some concrete recommendations on this topic in the near future.
    Roxanne Thames CPC, CPC-I, CEMC
    rthamescpci@gmail.com


    "Remember the greatest gift is not found in the store but in the heart of true friends"

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