|April 2004 · Vol. 16, No. 4
Screening after abnormal Pap: ‘Problem, not preventive’MELANIE
RN, CPC, MA
Ms. Witt, former program manager in the Department of Coding and Nomenclature at the American College of Obstetricians and Gynecologists, is an independent coding and documentation consultant. Reimbursement Adviser reflects the most commonly accepted interpretations of CPT-4 and ICD-9-CM coding. When in doubt on a coding or billing matter,
check with your individual payer.
Q One frustrating problem we frequently encounter is when the doctor wants a patient with a recent abnormal Pap to return every 6 months for repeat cytology.
Payers do not recognize Q0091 (screening Papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory) with the appropriate evaluation/management (E/M) code and with 795.0X (abnormal Pap smear) as the diagnosis. Because a Pap is not a routine procedure with our E/M visits, we typically bill out the Q0091 code.