Pathology/Lab Coding Alert

Question: Our lab performs a liquid-based screening Pap, and finding abnormality, refers the slide to the pathologist who diagnoses LGSIL. How should we code these procedures?

Tennessee Subscriber

Answer: The answer will be different depending on several factors such as the payer and lab method used.

Select the appropriate code for the liquid-based screening Pap smear technical charge based on your payer and lab method. For non-Medicare, choose from four CPT thin layer preparation codes depending on the screening/rescreening method:

• 88142 -- Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision
• 88143 -- ... with manual screening and rescreening under physician supervision
• 88174 -- ... screening by automated system, under physician supervision
• 88175 -- ... with screening by automated system and manual rescreening or review, under physician supervision
• For Medicare, select the appropriate HCPCS Level II "G" code based on the same criterion:
• G0123 -- Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision
• G0143 -- ... with manual screening and rescreening by cytotechnologist under physician supervision
• G0144 -- ... with screening by automated system under physician supervision
• G0145 -- ... with screening by automated system and manual rescreening under physician supervision

Pathologist interpretation takes additional code: For the interpretation of any abnormal Pap tests billed with a CPT code, you should report 88141 (Cytopathology, cervical or vaginal [any reporting system], requiring interpretation by physician).

For screening Medicare Pap tests using liquid-based technology, you should report the professional interpretation of an abnormal Pap using G0124 (Screening cytopathology, cervical or vaginal [any reporting system], collected in preservative fluid, automated thin layer preparation, requiring interpretation by physician).