Wiki Repeat PAP

[kimberlyapetro]

I am looking for some help on a topic that has bothered me for years. We have been told by one of our RHITs that we are incorrectly billing our follow up repeat PAPs after an abnormal or colposcopy. She has stated that an E/M is inappropriate since the patient is only in the office for a procedure, a PAP. There is minimal counseling on these visits since it is normally a follow up. There is not a CPT code for a PAP we have been using Q0091. I have stated that I believe this incorrect since that is a screening code designed for Medicare. There are other payers that do pay on the code but we are not using it as a screening code but a diagnostic code. I have found a few articles on the internet to prove my point including something on the ACOG site but she does not believe these are within CPT guidelines. Any help and hard documentation would be helpful.

Thank you!!

 

[megore]

The bigger question is what does SHE have to back up her statement? If your physician is performing the elements required for the level of E/M service being charged and it meets the level of medical decision making, I don't know why she would state that it isn't correct. In most cases the patients have not been seen for 3 to 6 months. It would be remiss of the physician to not go over patient history, do an exam of effected area to make sure there have been no changes, not to mention the medical decision making to complete a plan of care. I don't know of a physician that just takes a patient into an exam room, does a pap and walks out. As for billing the Q0091, I received the same "warning" documentation from ACOG. Again, I would ask her for the information that supports what she is telling you.