Pathology/Lab Coding Alert

Question: We’ve always reported Pap tests to one payer with 88174, but now they’re requiring G0144 for the same test. We used to use modifier 52 with 88174 if we were unable to complete the test and we didn’t report results due to a technical problem such as an imager malfunction. Can we use 52 with the G code?

Iowa Subscriber

Answer: You should not report modifier 52 (Reduced services) for a diagnostic test that your lab isn’t able to complete due to technical problems. For those cases, you don’t have a chargeable service.

As to which code you should report for a completed Pap test, that depends on the payer and the lab method you use. As you mentioned, you used to report 88174 (Cytopathology, cervical or vaginal [any reporting system], collected in preservative fluid, automated thin layer preparation; screening by automated system, under physician supervision), but your payer instructed you to switch to G0144 (Screening cytopathology, cervical or vaginal [any reporting system], collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervision).

These two codes describe the same lab method, but commercial payers often accept 88174 while Medicare and other government payers often require G0144. Follow payer guidance to choose the appropriate technical Pap test code for your services.