Pathology/Lab Coding Alert

Question: When our pathologist bills 88141 to interpret an abnormal liquid-based screening Pap test for a Medicare patient (G0123), were getting denials for the interpretation. How can we get paid for this service?

Missouri Subscriber

Answer: Because this is a screening test for a Medicare beneficiary, you are correct to bill the technical code for the Pap test using a HCPCS Level II code such as G0123 (Screening cytopathology, cervical or vaginal [any reporting system], collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision).Medicare requires you to use the appropriate HCPCS Level II code for screening Pap tests, which means tests system], requiring interpretation by physician). The HCPCS Level II requirement for screening Paps extends beyond the technical service. You need to select the pathologist interpretation code from HCPCS Level II as well.

Although CPT provides only one Pap interpretation code, you have several to choose from in HCPCS Level II. Make sure you match the Pap technical and interpretation codes based on the lab method.

Your case: The correct HCPCS Level II Pap interpretation code when your lab bills a G0123 technical code is G0124 (Screening cytopathology, cervical or vaginal [any reporting system], collected in preservative fluid, automated thin layer preparation, requiring interpretation by physician). If youll bill G0124 instead of 88141, you should get paid for the physician interpretation.