We're an Outside Lab, and having lots of discussion about what I-10 code(s) we should apply to screening Paps. I-10 description of Z01.411 and Z01.419 is for a routine gyn exam with or without cervical smear. This exam includes the pelvic exam and usually breast exam, and is likely to be our client providers' first choice for their screening Paps. Since these are clinical tests, we're obliged to have the providers' clinical diagnoses as our "first listed". As an outside facility, we are not performing either pelvic or breast exams; we are only processing and reporting on the cervical (or vaginal) smear itself. Therefore, Z12.4 would seem to be a better choice for our billing, if it weren't for the Excludes1 note telling us it can't be used with Z01.41_ ... which we'll have to report if the clinicican uses it! Any thoughts on how to resolve this?