Pathology/Lab Coding Alert

Use this clip-and-save chart to simplify your decisions

CPT has 14 Pap test codes, so accurately reporting your lab’s diagnostic work can be a challenge. Our experts say that if you’ll answer just four simple questions, you can select the right code every time.
 
Use the table “Diagnostic Pap Test CPT Codes ” below to help you narrow your choices as you answer the following questions:

1. Is the Pap test liquid-based?

The code definition states, “collected in preservative fluid, automated thin-layer preparation” if it is for a liquid-based Pap test. If the code definition does not include those words, it is for a conventional Pap smear, says Melanie Witt, RN, CPC-OGS, MA, an independent coding consultant based in Guadalupita, N.M.

Look at the table to find the “yes” or “no” in the liquid-based column. You’ve just narrowed your code selection to the top four codes (top gray area) or the remaining 10 codes, depending on your answer.

2. Does the code require or allow Bethesda reporting?

If the code specifically states “the Bethesda System” or “any reporting system,” the answer to this question is “yes.” If your answer to number 1 was “yes,” question 2 doesn’t narrow the field any more.

But if your answer to number 1 was “no,” you can look at the table and further narrow your choices to four codes for Bethesda (bottom gray area). “If the code doesn’t state ‘Bethesda’ or ‘any’ reporting system, it is not Bethesda,” Witt says. That narrows your choices to six non-Bethesda codes in the table (middle white area).

3. Is the initial screening manual or automated?

Remember, you’ve narrowed the field, and you only need to answer this question for the codes you’re still considering. The answer won’t help narrow your choices in the bottom gray area of the table, but it will in the other two areas.

4. What kind of rescreening occurs, if any?

Several Pap codes don’t mention rescreening, and the table lists those as “none.” The final column lists rescreening for the other codes as manual, computer-assisted or cell selection, according to the code definition.

When you answer this final question for the few codes you’re still considering, you have chosen the single most accurate Pap code for your lab’s diagnostic Pap test.