code for pap smear

which code must be used for pap smear S code or V code or Gcode??? I am so confused

S, V, or G code for Pap Smear

The V-code is the diagnosis code; whereas, the S and G codes are the Procedure codes. Both would depend on what insurance you are submitting the claim.

Your S-codes would be either S0610 or S0612 for annual gynecologic exam and I have only seen BCBS and Aetna reimburse these codes. In lieu of the S-Code, you may choose G0101 for "Breast and Pelvic Exam". Medicare will reimburse G0101. In addition, there are many commercial health plans that will reimburse G0101. If a pap is done, you may code Q0091 for "Obtaining the pap" and, again, it is up to the health plan whether they will pay it or not.

The V-codes that you should look at are:

V76.2 Special screening for malignant neoplasms, Cervix
Routine cervical Papanicolaou smear

V76.47 Special screening for malignant neoplasms, Vagina
Vaginal pap smear status-post hysterectomy for non-malignant condition
Use additional code to identify acquired absence of uterus (V88.01-V88.03)
Excludes: vaginal pap smear status-post hysterectomy for malignant condition (V67.01)

V72.3 Gynecological examination
Excludes:
cervical Papanicolaou smear without general gynecological examination (V76.2)
routine examination in contraceptive management (V25.40-V25.49)

V72.31 Routine gynecological examination
General gynecological examination with or without Papanicolaou cervical smear
Pelvic examination (annual) (periodic)
Use additional code to identify: human papillomavirus (HPV) screening (V73.81)
routine vaginal Papanicolaou smear (V76.47)

V72.32 Encounter for Papanicolaou cervical smear to confirm findings of recent normal smear following initial abnormal smear

There may be other V-codes that you may want to consider and you can find them in the ICD-9 or at this website:

http://icd9cm.chrisendres.com/index.php?action=child&recordid=11376

Charlene Endre-Burgett, MS, CMA (AAMA), CPM-MCS, CPC, CMSCS
Administrator, North Scottsdale Family Medicine
Blog: www.charleneburgett.wordpress.com
LinkedIn: www.linkedin.com/in/charleneburgett

s, v, or g code for a pap smear

I work for a billing company and we have not seen BCBS pay for an S code for about a year now. we have switched back to billing the 99394-99396. for Medicare it is G0101. However, I was recently told that I could get paid for the Q0091 with the 99394-99396. I have not seen this paid in at least a year (unless it is for a follow up to an abnormal screen)-what are your thoughts on this? I am trying to figure out if it is to be billed or not with the annual exam....(i have been told that it is part of the exam-and the q0091 is a path code). Your help would be greatly appreciated! :-)

BCBS-Preventive Visits and Well-Woman

BCBS changed their reimbursement policies about a year or two ago. They will not reimburse a well-woman on the same day as a preventive medicine visit. However, they will reimburse a well-woman on a different day! When they changed their policy, we changed ours...for everybody. We will no longer do a well-woman exam on the same day as a comprehensive physical. We have been doing this for about two years and our patients have accepted this fact and we are now being reimbursed for the services we are performing.

I have an article on my blog that discusses my perspective in more detail and can be found at:

https://charleneburgett.wordpress.com/2009/04/22/9/

Charlene Endre-Burgett, MS, CMA (AAMA), CPM-MCS, CPC, CMSCS
Administrator, North Scottsdale Family Medicine
Blog: www.charleneburgett.wordpress.com
LinkedIn: www.linkedin.com/in/charleneburgett

Q0091 Path code?

Q0091 is Obtaining the Pap. It is the actual scraping/brushing of the cervix. It is not to be charged by the lab, unless your lab tech is obtaining the pap...which I am sure is not the case!

Charlene Endre-Burgett, MS, CMA (AAMA), CPM-MCS, CPC, CMSCS
Administrator, North Scottsdale Family Medicine
Blog: www.charleneburgett.wordpress.com
LinkedIn: www.linkedin.com/in/charleneburgett