Pathology/Lab Coding Alert
Distinguish Purpose for Pap Codes
Question: Is it true that P3000 and HCPCS G0123 are exclusively for Medicare? If so, what codes should I report for Pap smears for non-Medicare payers?
Delaware Subscriber
Answer: Although most non-Medicare payers won't accept HCPCS Level II codes such as P3000 and G0123 for Pap smears, you should not necessarily always use these codes for Medicare.
Only use the HCPCS Level II codes to report screening Pap tests for Medicare patients, that is, tests ordered when the patient has no signs or symptoms of disease. Use the CPT Pap codes for other payers and for diagnostic Pap tests for Medicare patients. Physicians order diagnostic tests when the patient has a symptom that requires diagnosis.
You also have to choose the appropriate Pap test code based on the method that your lab uses to perform the test. The following table shows some pairs of Pap test codes that have similar definitions for HCPCS Level II and CPT codes:
Pathology/Lab Coding Alert
- Coding Frozen Sections With Touch Preps? Read This First
New edits could override CPT instructions that will affect your bottom line
Although CPT Codes [...] - You Be the Coder:
What's New With Ova and Parasites?
Question: We’ve always reported a trichrome stain on a fecal smear for ova and parasites [...] - NCCI Quick Update:
CMS Bundles Different Lab Methods
New edits limit your payment for multiple techniques
Labs have many methods [...] - Follow 5 Steps to Master Modifier 59 Claims
Warning: The OIG says your carrier should crack down on unbundling
When you use modifier 59 (Distinct [...] - Quick Quiz:
To Unbundle or Not to Unbundle...
Try your hand at these cases to see if you should use modifier 59
You've learned [...] - READER QUESTIONS:
Know When QW Will Get You Paid
Question: I can't find modifier QW in the CPT manual , but I've been [...] - READER QUESTIONS:
Distinguish Purpose for Pap Codes
Question: Is it true that P3000 and HCPCS G0123 are exclusively for [...] - READER QUESTIONS:
Reason for Stain Dictates Code
Question: Our pathologist examined the following stains for a liver biopsy: iron, trichrome, reticulin and [...] - READER QUESTIONS:
Medicare Doesn't Cover Routine Protime Tests
Question: Why don't we get paid when our lab performs PT and PTT tests preoperatively [...]
