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Ob-Gyn Coding Alert

READER QUESTIONS:

Preventive Codes in Lieu of S0612 a Good Thing

Published on Fri May 26, 2006

Question: What is G0145 for, and do all carriers accept the code? Also, does everyone get paid using S0612 for routine visits? Blue Cross/Blue Shield of Massachusetts started denying our claims with this code, and we are now using 99384-99387 and 99394-99397 for preventive services. Is this correct?


Massachusetts Subscriber

 
Answer: Code G0145 (Screening cytopathology, cervical or vaginal [any reporting system], collected in preservative fluid, automated thin-layer preparation, with screening by automated system and manual rescreening under physician supervision) is the Medicare code that the lab bills for the screening Pap smear. You shouldn't report this code, because your physician office is not doing the interpretation.

If Blue Cross Blue Shield of Massachusetts is now paying on preventive codes (99384-99387 and 99394-99397), you are probably better off in any case. The preventive codes have relative value units assigned, but BCBS developed S0612 (Annual gynecological exam; established patient) for its own reporting purposes.
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