Wiki Help?! Well Woman Coding

[anne32]

I am needing help with coding for well woman exams. If it is during the annual exam we use a prev code. It if it a repeat pap, we use 99212-99215. We also do our own lab billing. So if it is during the annual exam, we are coding for the pap (88142) and also the HPV lab (88175). Does both of these fall under the 88142 or should we be coding them separately? Also what dx should we use for the annual exam and also for a repeat pap? Any help is appreciated. I guess I'm just a little confused about it and would like someone to explain coding for this so I know I have the correct understanding. Thanks!!!

 

[mitchellde]

if you are the physician office and are not performing your own lab analysis then you do not bill the 88142 or the 88175 only the visit level either office level or preventive. The dx for annual well woman is the V72.31, you do not add the V76.2 however you do add the V76.47 and/or the V73.81. The repeat PAP if the annual is abnormal is the V72.32

 

[anne32]

We do our own labs. Is it correct to bill both the 88142 for the pap and the 88175 for the HPV screen? And are these the correct codes? I am also wondering about billing Medicare for the annual exam. For an annual exam is it correct to bill G0101 with a prev visit along with the labs listed above?

 

[SheliaHill]

anne32

MCare pays for a well annual visit (eg: pelvic/breast exam) every two years.
G0101 = V72.31
Q0091 = V76.2
Breast Mamogram order: Dx: V76.12
Provider owned Mammogram office equipment: G0202, 77052

MCare problem pap can be performed x1 annually w/problem diagnosis:
Ascus: 795.0X (x = look for applicable 5th digit)
CIN I: 622.1X (x = look for applicable 5th digit)

MCare/Commercial research recommends patient should have 3 clean paps, before returning to routine/well service coding/billing.

Provider owned office lab:
88142 = thin prep pap screening
88175 = thin prep pap screening, automated system & manual rescreening review

I hope this is helpful.