redo pap smear

Pt had routine physical & pap smear on Dec. 2014. For the pap result, the laboratory was unable to provide the result due to unsatisfactory specimen adequacy. So, we did another pap last Jan. 2015 Do I have to bill the E/M 993xx or G0101 (Pt have Cofinity Plan). Do I have to put a modifier to tell the insurance company that this is a repeat pap? Help. Thanks!

re: redo pap smear

In the OBGYN practice that i code for if a patient comes back for a repeat pap, we normally bill for a low level office visit 99212 with the speciemen handling code 99000, you would not bill for the preventive medicine code again as you are not performing the whole exam and per the CPT® guidelines it has to be at least 1 year before you can bill for those services. I only use the Q code when I am billing MCR and only for the first preventive medicine charge. If a MCR patient comes back for a repeat pap we bill it as the office visit of 99212 and the speciemen handling code. Per the MCR guidelines you can only bill for a pap every two years. If the patient is high risk tho, you may use V15.89, but this must be established at the previous preventive medicine exam.

you should also use the correct DX code as to why the patient is having the Pap repeated, should be in the DX range of the 795.0....codes as to why the pap had to be repeated. This only for commerical insurance's though.