Wiki Paps coding???????

[rizzo9]

I feel like I am losing my mind and I need some help on this one.

If a patient with a history of abnormal bleeding (626.6) goes in for a screening exam of the cervix (V76.2) and it is determined that the patient has ASC-US (795.01), what is the proper way to bill the 88141 and 88142 for the pathologist?

Thanks!

 

[Kisha]

paps coding

You would could for the screening and the asc ICD-9 codes and then you would more than likely bill 88141. Unless your Dr. collected the speciemn under these terms:

88142-Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision

Hope this helps..

 

[whaleheadking]

The primary dx is the screening. You would append the ASC-US as the secondary to indicate the cytologist's interpretation. A screening pap remains a screening pap. The follow-up should have the ASC-US as the clinical indication because it will no longer be a screening.

This becomes especially clear when using HCPCS to describe the procedure instead of CPT. The HCPCS code will specify the test was a screening, so the dx code for its justification has to match in order for CMS to understand what was done and why. The follow-up is reported to CMS as a CPT code.

Good luck,
WK
Surgical Pathology Coding Blog