Pap

we are an Internal Medicine Office and we do pap on our women patient's. For BC/BS does any one know what is the billable procedure code. we have been using Procedure Q0091 and bc/bs are denying it for the following reason: it is not a covered code under bc/bs. Can someone please help me.

Thank You in advance

re: PAP

For a Well Woman exam on BCBS, use either S0610 or S0612 depending on New or Established. Check with the plan to see what reimbursement is in your area and under your contract. It will be $100-150 depending on the code. You can also code Q0091 for obtaining the pap, however, it may not be covered separately. Do NOT code a Preventive Medicine visit (9938x-9939x) on the same day! You can code an office visit with a modifier -25 if there was a significant, separately identifiable medical reason.

We also receive reimbursement on the S0610 and S0612 from Aetna. I don't know of any other plan that will reimburse these HCPCS codes. For other plans, we code G0101 instead of the S-codes.

The G and Q codes are not just for Medicare as many people think!


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

re: PAP

Thanks For your input it really helped