Internal Medicine Coding Alert

Question: I recently asked Medicare about coding for a Pap smear. My CPT codes are correct, but they said my diagnosis (V72.3) is not. Is there another code I should use?

New York Subscriber

Answer: Code V72.3 is the ICD-9 code for a gynecological exam, according to Catherine Brink, CMM, CPC, president of Healthcare Resource Management Inc., based in New Jersey. Medicare states that Pap tests for patients who have not had a Pap test during the preceding three years and/or are considered to be of low cancer risk can be reported using codes V72.6 (laboratory examination) and V76.2 (special screening for malignant neoplasms, cervix).

If the patients medical history or other findings show that she is at high risk of developing cervical cancer and her physician recommends she have a Pap test performed more frequently than every three years, use V72.6 and V15.89 (other specified personal history presenting hazards to health). High-risk factors for cervical and vaginal cancer are early onset of sexual activity (under l6 years of age), multiple sex partners (five or more in a lifetime), history of sexually transmitted disease (including HIV infection), and fewer than three negative Pap smears within the previous seven years. A high-risk factor for vaginal cancer is diethylstilbestrol (DES)-exposed daughters of women who took DES during pregnancy.


Additional Reader Question information was provided by Kathy Pride, CPC, an internal medicine coder and coding supervisor for Martin Memorial Medical Group, a 350-bed hospital in Stuart, Fla.