Ob-Gyn Coding Alert

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Clarify This Medicare High Risk Pap Result Requirement

Adhere to standard ACOG, ASCCP, and CMS protocol.A subscriber like you wrote in to the Ob-gyn Coding Alert editor to ask a question about the article, "Quick Tips: Untangle Your Well-Woman Exam Coding With This Advice," featured on page four of the 2001, volume 14, number A issue, which describes Medicare high risk coding.This article describes one of the high risk elements as the "absence of three consecutive negative Pap results" while Medicare phrases this as "fewer than three negative Pap smears within the previous seven years.""The Coding Institute's interpretation, to me, sounds like one abnormal Pap smear and the patient qualifies for high-risk -- which is true for childbearing patients but not non-child-bearing women," points out Silah Patterson, CPC, COBGC, coding manager for Women's Health USA in Avon, Connecticut. Is this correct?Key: For postmenopausal women, fewer than three negative Pap smears within a seven year time period qualifies her as [...]
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