# New to OBGYN..need PAP help



## 1073358 (Jun 17, 2009)

Is it appropriate to code an EM along with the 88175 pap code, when the patient ONLY comes in for a pap, no other complaints or issues? There is some debate about billing it for the providers time, but I am not sure it meets the criteria of" above and beyond" or not


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## pahtrisha (Jun 17, 2009)

The E/M code selected for a visit to collect a pap smear specimen should be based, of course, on the documentation in the record. Usually, if it's a simple re-pap, this will be a low level visit, and the ICD9 will usually be from the 795.xx series, unless it is a pap to confirm a recent normal pap following an earlier abnormal pap (eg ascus), in which case it's a V code....sorry, don't have it off the top of my head.

Keep in mind that collection of a pap specimen is included in the E/M code whether it is a problem visit or a screening exam, according to CPT.  I hear that SOME payers other than medicare will pay for Q0091.  If your payers DO pay Q0091, then it may not be appropriate to also bill an E/M if the visit, as you say, is just a simple, quick, repap. 

Why would you be billing for the pap test itself?  Doesn't the cytology lab bill for the actual processing and interpretation of the smear??
Patricia, CPC, COBGC


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## kbarron (Jun 18, 2009)

When folks come in for a pap only, my docs give the 9939_ with Q0091. They also use V72.31. These are not always pd but our practices get rvu's. The 88175 is for the lab code only.


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