Ob-Gyn Coding Alert

Question: How do I code when a Pap smear is performed during a well-woman visit? ICD-9 defines V72.3 as Papanicolaou cervical smear as part of general gynecological examination and pelvic exam (annual, periodic). It also defines V76.2 as routine cervical Papanicolaou smear and excludes that as part of a general gynecological exam. So, wouldn't V72.3 be the correct code for the entire well-woman visit? Wouldn't V76.2 be used when a Pap smear is done at some time other than the routine gyn exam?
Arkansas Subscriber   Answer: You are correct, but if you must supply a specific code to the laboratory, they will probably need to bill it as V76.2 (special screening for malignant neoplasms, cervix) because that is the only part performed. Normally, you will not bill the Pap code unless you are using a reference lab and the only other charge you might be billing that is associated with the Pap collection would be 99000 (handling and/or conveyance of specimen for transfer from the physician's office to a laboratory) for a handling fee. The handling fee can be billed with either V72.3 (gynecological examination) or V76.2, which is specific only to the Pap.