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Thread: Medicare pap high risk definintion

  1. #1

    Default Medicare pap high risk definintion

    AAPC: Back to School
    Could someone please explain to me why 'fewer than 3 negative pap smears within the previous 7 years' would be defined as high-risk for Medicare? It appears a history of positive abnormal pap smears would be high risk instead!
    Thanks for your help!

  2. #2
    Join Date
    Apr 2007


    My intrepertation of this code is when a patient does not come in for routine annuals and therefore there would not be any pap smears therefore no 3 negative ones.

    For example:

    Jane Doe brings in her 60 year old mother for her annual because she has not been seen in 10 years. She can have a pap smear every year for the next three years even if they are all negative and Medicare will pay if you use that V code.
    Christina Lee Wagner, CPC, CPC-H

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