Medical Billing Forum
Billing => Billing => : Christine_1 August 15, 2008, 12:41:39 AM
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I need help understanding how to code paps. If it is a screening pap you would just bill the preventative cpt and appropriate v code, right? For a diagnostic where the specimen is obtained and sent to an outside lab, how are these coded? What I have seen done is E/M cpt used, along with 88141 and 88174 and the problem DX code. This doesn't seem correct. I have read CPT so many times on the pap codes and the more I read, the more confused I get. Thanks in advance for any help. ::)
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Sorry for the delay, I was away for the weekend and I had to look this one up.
It would seem fairly easy to bill for a pap smear, but it can be quite complicated. If it is a screening pap then you need to use the appropriate dx, V72.31 or V76.2 for low risk or V15.89 for high risk, and then Medicare requires the G0101 hcpcs code for screening paps. You can bill an E&M with the pap if there was a reason for the ov, but you should use the 25 modifier.
If it is a medical pap, then you would use the appropriate ICD diagnosis code and the appropriate medical pap code, 88141 & 88174 would work. Again you can bill the E&M with the pap.
Hope that helps
Michele
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that is only if it is done at the lab correct? If the physician does it don't you bill the Q0091?
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I actually had to research that answer and the info I found comes from a division of WebMD. It states that the G0101 is for the pelvic exam and Q0091 is for the collection of the pap smear specimen. So it sounds like you should actually be billing both codes. The lab part is a separate CPT.
Michele