# physicals -We had a patient



## gmlittle (Jul 22, 2008)

We had a patient come into the office for her annual physical, the first visit was w/o pap and we billed with 99395, she came back the following week for the pap need to know what procduere to bill the pap with?

Any help

Gina Little, CPC


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## rhongar (Jul 22, 2008)

Gina,

I would most likely code it with the V76.2 for the ICD-9 and then code the level of E&M that the documentation supports. 

have a great day and I hope you find your answer.

Rhonda B.


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## mstenochs (Jul 22, 2008)

If it was a routine pap it should be billed Q0091 with dx of V72.31 routine gyn exam
Hope this helps


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## dmaec (Jul 22, 2008)

I'd code out a very low level E/M (for the providers time) and I'd code the 
V76.2 code.
we've had this happen often, patient came back for "pap" only - 

we do use the Q0091, but only for Medicare patients. (and G0123)


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## jlund1 (Jul 22, 2008)

At our family care clinic we would report a 88142 with V72.31 (if medicare pt Q0091 with V76.2) and we usually no charge the pt for the visit ( unless they come in for a reason)


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## Lisa Bledsoe (Jul 23, 2008)

jlund1 said:


> At our family care clinic we would report a 88142 with V72.31 (if medicare pt Q0091 with V76.2) and we usually no charge the pt for the visit ( unless they come in for a reason)



88142 should only be reported by the lab/pathologist reading the pap...unless you set up and read your paps in your office...


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## mkj2486 (Aug 3, 2008)

for pap's we bill 88175 under the physician perfoming the collection w/dx of v72.31


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## lorrpb (Aug 5, 2008)

I am curious as to why it wasn't done as part of the annual physical? The insurance company could see this as yo-yoing. I agree with Lisa that any of the 88xxx codes are for the reading and interp of the pap. You might consider using 99000 for the specimen collection, since that's really all that was done. I'm not sure it qualifies as even a low level E/M. 

The dx code should be 76.2 as this is the pap only, not a full gyn exam.


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## Lisa Bledsoe (Aug 5, 2008)

mkj2486 said:


> for pap's we bill 88175 under the physician perfoming the collection w/dx of v72.31



This is still a lab/path code that should only be reported by the lab setting up the smear and the pathologist reading the smear.  The providers office who collects the smear should not use any of the pap codes.  99000 could be considered as previously suggested, but it probably won't be paid.


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## knight999 (Aug 5, 2008)

*Pap*

The pap was a portion of her age/gender appropriate physical.  This should be a no charge visit.


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## jas0426 (Aug 5, 2008)

Have to agree, we just had this same situation and I had to do extensie research on it to prove that we should not be billing the pathology codes.  I know when I worked in Family Practice, many times a pt would have to come back due to cycle or whatever for their pap and it was a no charge visit b/c everything was included with the physical.  OF course if they start trying to bring up other issues, then you could code E/M with those dx.


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