Pathology/Lab Coding Alert

Question: Our lab performs Pap exams using the Thin Prep method, and we've had conflicting advice about what code to use. Would you please tell us the correct code?


Tennessee Subscriber

Answer: If your lab manually reads Thin Prep cervical cytology slides, you should report 88142 (Cytopathology, cervical or vaginal [any reporting system], collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision).

If your lab is using the Cytyc Thin Prep Imaging System, however, you should report 88175 (Cytopathology, cervical or vaginal [any reporting system], collected in preservative fluid, automated thin layer preparation; with screening by automated system and manual rescreening or review, under physician supervision). This system requires dual review of each slide by both the imager and the cytotechnologist, so you should not use 88174 (Cytopathology, cervical or vaginal [any reporting system], collected in preservative fluid, automated thin layer preparation; screening by automated system, under physician supervision).

You should also realize that if the Pap tests are for cervical cancer screening for Medicare patients, not for diagnostic purposes based on signs or symptoms of disease, you should use the following codes:

• G0123--Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin-layer preparation, screening by cytotechnologist under physician supervision.

• G0145--Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin-layer preparation, with screening by automated system and manual rescreening under physician supervision.