Pathology/Lab Coding Alert

Question: We-re getting denials when physicians order screening Pap smears as part of the annual well-woman exam. Why are these charges denied, and what can we do about it? Mississippi Subscriber Answer: Physicians often report V72.31 (Routine gynecological examination) to order a Pap smear as part of the gynecological exam because ICD-9 states that the code describes the service "with or without Papanicolaou cervical smear." But many lab payers won't cover a Pap smear linked to V72.31 because the lab does not perform the gynecological exam. Do this: You should use the diagnosis code for a routine Pap smear -- V76.2 (Special screening for malignant neoplasms; cervix) as the ordering diagnosis for the lab test. Even if the physician uses V72.31 on the lab order, you can change the code to V76.2. -- Reader Questions and You Be the Coder were prepared with the assistance of R.M. Stainton Jr., MD, president of Doctors- Anatomic Pathology Services in Jonesboro, Ark.