CPT Codes For PAP Smears

Pap Smear
by euthman

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 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.

Find More Pap Smear Articles

Question by Amy: What causes a pap smear to come back with abnormal a typical cells?
I got a pap smear and it came back showing abnormal a typical cells. im also experiencing more discharge than normal. the discharge looks normal. but i was just wondering what causes pap smears to come back that way… what it could be…

Best answer:

Answer by Sierra
My doctor once told me that it doesn’t always mean something bad. They’ll just have to do more tests. Make a follow up appointment and hope for the best. Don’t worry you’ll be fine.

Give your answer to this question below!

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3 Responses to “CPT Codes For PAP Smears”

  1. Ghee Says:

    Atypical means that the cells were not “typical” cells like would be found normally – Your Dr. should re-do your Pap – usually in 6 months – It does not mean that cancer or anything else diagnostic was found – just that what was there wasn’t the “normal” kind of cell that would be sent for a Pap smear – You could have some infection – or endometriosis, or it just wasn’t a “good” scraping (didn’t have enough cells to test) –
    Don’t panic until you have had another one done – (the 6 months wait is usually because of Insurance not paying to retest) – You can always opt to pay for the test yourself (if you can afford it) -
    The discharge you are having may not have anything to do w/ the test results – unless you have an infection – and that could have “masked” the results —
    Just get tested again when your Dr. resommends -

  2. daisyrose Says:

    a pap smear is done for cancer cells and infection ,,, nothing to o with discharge

  3. jake696 Says:

    Usually…HPV is the cause of abnormal cells being seen on Pap smears.

    research: human papilloma virus

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