Pathology/Lab Coding Alert

Question: Our lab has a gynecologist client who is trying to charge 88141 for interpreting Pap tests. Can he do this?

Iowa Subscriber

Answer: From a CPT® coding perspective, any physician who is qualified to use a code may do so. In other words, physicians are not restricted to using codes only in their area of specialty.

That said, your gynecologist client probably should not be charging for a Pap interpretation (88141, Cytopathology, cervical or vaginal [any reporting system], requiring interpretation by physician). There are a couple of reasons this would be inappropriate.

First: If your lab identified an abnormal Pap test, your pathologist probably already performed the interpretation and billed 88141. The gynecologist could not bill for the same procedure for the same service date. If the Pap test was normal and the pathologist did not perform 88141, no one else should perform the interpretation either, because the code states that the service is for tests “requiring interpretation by a physician,” which means abnormal tests. 

Second: Performing an 88141 service requires expertise at evaluating Pap slides under a microscope and interpreting the findings in very specific terms, such as atypical squamous cells of undetermined significance (ASCUS). Also, the physician performing the interpretation must be qualified to do so under the Clinical Laboratory Improvement Amendments (CLIA). That makes it very unlikely that a gynecologist would be qualified to perform the service.