Know the CPT Codes: Medicare Repeat Pap Smears

When a patient comes back to your office for a repeat Pap smear

, you need to measure your options of E/M and specimen handling codes as well as diagnosis codes. Take this test to see how you fare and put off payment from slipping through your fingers.

Question 1: What CPT code should you report when a patient comes in for a second Pap smear? And why?

Answer: Here's what CPT codes to use.

When the patient comes in for a Pap smear second time round, submit the right E/M office visit code. You are likely to be able to report 99212 for this visit as the patient will come in only for the Pap smear and CPT does not include a specific code for taking the Pap. Code 99212 carries 1.08 RVUs, unadjusted for geography. This translates to about $31 for this visit (using the new conversion factor of 28.3868).

Question 2: Will you get reimbursement for handling the repeat Pap smear? Why or why not?

Answer 2: Handling the specimen depends on payer

Some private payers will compensate for handling the repeat Pap smear specimen. However, Medicare carriers think the collection and handling part of a problem E/M service, and you shouldn't code for it separately.

To add to it, Medicare will not reimburse for Q0091 for the repeat Pap smear as it's a diagnostic test. In this case, Medicare thinks of the service as a problem E/M, not a preventive screening, and the specimen collection is part of the E/M service.

For more answers to questions such as this, sign up for a CPT coding website. When you sign up for one, you'll get answers to all the CPT coding queries you may have.

Know the CPT Codes: Medicare Repeat Pap Smears

By: James Smith

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