Guest guest Posted May 2, 2006 Report Share Posted May 2, 2006 Ok- now I'm really confused. Medicare reimburses $47 for code G0101 (cervical or vaginal cancer screening; pelvic and clinical breast exam). Then there is code 88142 (cytopathology, cervical or vaginal...manual screening under physician supervision). Is that the code the pathology lab charges? I ask because I have seen other office superbills with this CPT code, when all they are doing is collecting the specimen, not performing the actually cytology. So I had come to think that it simply meant reviewing the report. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 2, 2006 Report Share Posted May 2, 2006 RE Billing for procedure 1) Fee for examination. 2) Fee for " collection service. " Not sure how well I get paid for this, though, as I haven't really done enough PAPs lately to track such EOBs, AND... I have a billing service (!) who usually scrubs alot of these claims for me (yes, my added expense, but it helps me). But, this is the main way of doing things... Dr Matt Levin Pittsburgh, PA PAPs/pathology > Ok- now I'm really confused. Medicare reimburses $47 for code G0101 > (cervical or vaginal cancer screening; pelvic and clinical breast > exam). Then there is code 88142 (cytopathology, cervical or > vaginal...manual screening under physician supervision). Is that the > code the pathology lab charges? I ask because I have seen other > office superbills with this CPT code, when all they are doing is > collecting the specimen, not performing the actually cytology. So I > had come to think that it simply meant reviewing the report. > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 2, 2006 Report Share Posted May 2, 2006 RE Billing for procedure 1) Fee for examination. 2) Fee for " collection service. " Not sure how well I get paid for this, though, as I haven't really done enough PAPs lately to track such EOBs, AND... I have a billing service (!) who usually scrubs alot of these claims for me (yes, my added expense, but it helps me). But, this is the main way of doing things... Dr Matt Levin Pittsburgh, PA PAPs/pathology > Ok- now I'm really confused. Medicare reimburses $47 for code G0101 > (cervical or vaginal cancer screening; pelvic and clinical breast > exam). Then there is code 88142 (cytopathology, cervical or > vaginal...manual screening under physician supervision). Is that the > code the pathology lab charges? I ask because I have seen other > office superbills with this CPT code, when all they are doing is > collecting the specimen, not performing the actually cytology. So I > had come to think that it simply meant reviewing the report. > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 2, 2006 Report Share Posted May 2, 2006 I've never seen a physician office (non pathologist) that performs the actual cytopathology on a PAP. Is that really what you meant or am I just misunderstanding. I think the 88142 code is for non-Medicare insurances while the G code is for Medicare only. I rarely ever do office PAPS though so I could be wrong. For me, these are too time consuming to be worth it. They all go to GYN. PAPs/pathology Ok- now I'm really confused. Medicare reimburses $47 for code G0101 (cervical or vaginal cancer screening; pelvic and clinical breast exam). Then there is code 88142 (cytopathology, cervical or vaginal...manual screening under physician supervision). Is that the code the pathology lab charges? I ask because I have seen other office superbills with this CPT code, when all they are doing is collecting the specimen, not performing the actually cytology. So I had come to think that it simply meant reviewing the report. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 2, 2006 Report Share Posted May 2, 2006 I've never seen a physician office (non pathologist) that performs the actual cytopathology on a PAP. Is that really what you meant or am I just misunderstanding. I think the 88142 code is for non-Medicare insurances while the G code is for Medicare only. I rarely ever do office PAPS though so I could be wrong. For me, these are too time consuming to be worth it. They all go to GYN. PAPs/pathology Ok- now I'm really confused. Medicare reimburses $47 for code G0101 (cervical or vaginal cancer screening; pelvic and clinical breast exam). Then there is code 88142 (cytopathology, cervical or vaginal...manual screening under physician supervision). Is that the code the pathology lab charges? I ask because I have seen other office superbills with this CPT code, when all they are doing is collecting the specimen, not performing the actually cytology. So I had come to think that it simply meant reviewing the report. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 2, 2006 Report Share Posted May 2, 2006 I've never seen a physician office (non pathologist) that performs the actual cytopathology on a PAP. Is that really what you meant or am I just misunderstanding. I think the 88142 code is for non-Medicare insurances while the G code is for Medicare only. I rarely ever do office PAPS though so I could be wrong. For me, these are too time consuming to be worth it. They all go to GYN. PAPs/pathology Ok- now I'm really confused. Medicare reimburses $47 for code G0101 (cervical or vaginal cancer screening; pelvic and clinical breast exam). Then there is code 88142 (cytopathology, cervical or vaginal...manual screening under physician supervision). Is that the code the pathology lab charges? I ask because I have seen other office superbills with this CPT code, when all they are doing is collecting the specimen, not performing the actually cytology. So I had come to think that it simply meant reviewing the report. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 2, 2006 Report Share Posted May 2, 2006 ,It took me a while to figure out how to charge for Paps. My understanding is that there is no CPT code for performing/collecting a Pap smear. It is considered part of any regular E/M encounter. Therefore for a routine physical, you use the appropriate Preventive Health code (99384-99387 for New patients, 99394-99397 for Established patients). see Making Sense of Preventive Medicine Coding - http://www.aafp.org/fpm/20040400/49maki.htmlIf a Pap is done separately from a preventive exam, then you would use the appropriate E/M outpatient visit code (99202-99205 for New, 99212-99215 for Established). see Coding and Documentation: Coding Pap smears - http://www.aafp.org/fpm/20010900/coding.htmlFor Medicare patients, Medicare does not cover routine preventive visits (except for an Initial Preventive Physical Exam for newly enrolled Medicare beneficiaries and must be completed within 6 months after Part B coverage begins) but it does pay for collection of a Pap smear (once every 2 years for low risk, annually for high risk) using the HCPCS code Q0091, and for the screening pelvic and breast exam using the code G0101. This website also gives the appropriate ICD9 codes to use: http://www.oknmmedicare.com/provider/reference/premedquickref.htmIf you use these Medicare codes with an E/M code, you also need to add the -25 modifier to the E/M code as a significant and separately identifiable service. The CPT code 88142 is for "Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision" and is a laboratory charge. SetoSouth Pasadena, CA RE Billing for procedure 1) Fee for examination. 2) Fee for "collection service." Not sure how well I get paid for this, though, as I haven't really done enough PAPs lately to track such EOBs, AND... I have a billing service (!) who usually scrubs alot of these claims for me (yes, my added expense, but it helps me). But, this is the main way of doing things... Dr Matt Levin Pittsburgh, PA PAPs/pathology > Ok- now I'm really confused. Medicare reimburses $47 for code G0101 > (cervical or vaginal cancer screening; pelvic and clinical breast > exam). Then there is code 88142 (cytopathology, cervical or > vaginal...manual screening under physician supervision). Is that the > code the pathology lab charges? I ask because I have seen other > office superbills with this CPT code, when all they are doing is > collecting the specimen, not performing the actually cytology. So I > had come to think that it simply meant reviewing the report. > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 2, 2006 Report Share Posted May 2, 2006 ,It took me a while to figure out how to charge for Paps. My understanding is that there is no CPT code for performing/collecting a Pap smear. It is considered part of any regular E/M encounter. Therefore for a routine physical, you use the appropriate Preventive Health code (99384-99387 for New patients, 99394-99397 for Established patients). see Making Sense of Preventive Medicine Coding - http://www.aafp.org/fpm/20040400/49maki.htmlIf a Pap is done separately from a preventive exam, then you would use the appropriate E/M outpatient visit code (99202-99205 for New, 99212-99215 for Established). see Coding and Documentation: Coding Pap smears - http://www.aafp.org/fpm/20010900/coding.htmlFor Medicare patients, Medicare does not cover routine preventive visits (except for an Initial Preventive Physical Exam for newly enrolled Medicare beneficiaries and must be completed within 6 months after Part B coverage begins) but it does pay for collection of a Pap smear (once every 2 years for low risk, annually for high risk) using the HCPCS code Q0091, and for the screening pelvic and breast exam using the code G0101. This website also gives the appropriate ICD9 codes to use: http://www.oknmmedicare.com/provider/reference/premedquickref.htmIf you use these Medicare codes with an E/M code, you also need to add the -25 modifier to the E/M code as a significant and separately identifiable service. The CPT code 88142 is for "Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision" and is a laboratory charge. SetoSouth Pasadena, CA RE Billing for procedure 1) Fee for examination. 2) Fee for "collection service." Not sure how well I get paid for this, though, as I haven't really done enough PAPs lately to track such EOBs, AND... I have a billing service (!) who usually scrubs alot of these claims for me (yes, my added expense, but it helps me). But, this is the main way of doing things... Dr Matt Levin Pittsburgh, PA PAPs/pathology > Ok- now I'm really confused. Medicare reimburses $47 for code G0101 > (cervical or vaginal cancer screening; pelvic and clinical breast > exam). Then there is code 88142 (cytopathology, cervical or > vaginal...manual screening under physician supervision). Is that the > code the pathology lab charges? I ask because I have seen other > office superbills with this CPT code, when all they are doing is > collecting the specimen, not performing the actually cytology. So I > had come to think that it simply meant reviewing the report. > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 2, 2006 Report Share Posted May 2, 2006 ,It took me a while to figure out how to charge for Paps. My understanding is that there is no CPT code for performing/collecting a Pap smear. It is considered part of any regular E/M encounter. Therefore for a routine physical, you use the appropriate Preventive Health code (99384-99387 for New patients, 99394-99397 for Established patients). see Making Sense of Preventive Medicine Coding - http://www.aafp.org/fpm/20040400/49maki.htmlIf a Pap is done separately from a preventive exam, then you would use the appropriate E/M outpatient visit code (99202-99205 for New, 99212-99215 for Established). see Coding and Documentation: Coding Pap smears - http://www.aafp.org/fpm/20010900/coding.htmlFor Medicare patients, Medicare does not cover routine preventive visits (except for an Initial Preventive Physical Exam for newly enrolled Medicare beneficiaries and must be completed within 6 months after Part B coverage begins) but it does pay for collection of a Pap smear (once every 2 years for low risk, annually for high risk) using the HCPCS code Q0091, and for the screening pelvic and breast exam using the code G0101. This website also gives the appropriate ICD9 codes to use: http://www.oknmmedicare.com/provider/reference/premedquickref.htmIf you use these Medicare codes with an E/M code, you also need to add the -25 modifier to the E/M code as a significant and separately identifiable service. The CPT code 88142 is for "Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision" and is a laboratory charge. SetoSouth Pasadena, CA RE Billing for procedure 1) Fee for examination. 2) Fee for "collection service." Not sure how well I get paid for this, though, as I haven't really done enough PAPs lately to track such EOBs, AND... I have a billing service (!) who usually scrubs alot of these claims for me (yes, my added expense, but it helps me). But, this is the main way of doing things... Dr Matt Levin Pittsburgh, PA PAPs/pathology > Ok- now I'm really confused. Medicare reimburses $47 for code G0101 > (cervical or vaginal cancer screening; pelvic and clinical breast > exam). Then there is code 88142 (cytopathology, cervical or > vaginal...manual screening under physician supervision). Is that the > code the pathology lab charges? I ask because I have seen other > office superbills with this CPT code, when all they are doing is > collecting the specimen, not performing the actually cytology. So I > had come to think that it simply meant reviewing the report. > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 2, 2006 Report Share Posted May 2, 2006 , Your posts are so informative. Thank you for the effort you consistently put in to find useful information and share it in an organized fashion. When I grow up, I want to be just like you! Tim > , > It took me a while to figure out how to charge for Paps. My > understanding is that there is no CPT code for performing/collecting a > Pap smear. It is considered part of any regular E/M encounter. > Therefore for a routine physical, you use the appropriate Preventive > Health code (99384-99387 for New patients, 99394-99397 for > Established patients). see Making Sense of Preventive Medicine Coding > - http://www.aafp.org/fpm/20040400/49maki.html > > If a Pap is done separately from a preventive exam, then you would use > the appropriate E/M outpatient visit code (99202-99205 for New, > 99212-99215 for Established). see Coding and Documentation: Coding Pap > smears - http://www.aafp.org/fpm/20010900/coding.html > > For Medicare patients, Medicare does not cover routine preventive > visits (except for an Initial Preventive Physical Exam for newly > enrolled Medicare beneficiaries and must be completed within 6 months > after Part B coverage begins) but it does pay for collection of a Pap > smear (once every 2 years for low risk, annually for high risk) using > the HCPCS code Q0091, and for the screening pelvic and breast exam > using the code G0101. This website also gives the appropriate ICD9 > codes to use: http://www.oknmmedicare.com/provider/reference/ > premedquickref.htm > > If you use these Medicare codes with an E/M code, you also need to add > the -25 modifier to the E/M code as a significant and separately > identifiable service. The CPT code 88142 is for " Cytopathology, > cervical or vaginal (any reporting system), collected in preservative > fluid, automated thin layer preparation; manual screening under > physician supervision " and is a laboratory charge. > > Seto > South Pasadena, CA > > > >> RE Billing for procedure >> >> 1) Fee for examination. >> 2) Fee for " collection service. " >> >> Not sure how well I get paid for this, though, as I haven't really >> done >> enough PAPs lately to track such EOBs, AND... I have a billing >> service (!) >> who usually scrubs alot of these claims for me (yes, my added >> expense, but >> it helps me). >> >> But, this is the main way of doing things... >> >> Dr Matt Levin >> Pittsburgh, PA >> PAPs/pathology >> >> >> > Ok- now I'm really confused. Medicare reimburses $47 for code G0101 >> (cervical or vaginal cancer screening; pelvic and clinical breast >> exam). Then there is code 88142 (cytopathology, cervical or >> > vaginal...manual screening under physician supervision). Is that >> the >> > code the pathology lab charges? I ask because I have seen other >> office superbills with this CPT code, when all they are doing is >> collecting the specimen, not performing the actually cytology. So I >> had come to think that it simply meant reviewing the report. >> > >> > >> > >> > >> > >> > >> > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 2, 2006 Report Share Posted May 2, 2006 , Your posts are so informative. Thank you for the effort you consistently put in to find useful information and share it in an organized fashion. When I grow up, I want to be just like you! Tim > , > It took me a while to figure out how to charge for Paps. My > understanding is that there is no CPT code for performing/collecting a > Pap smear. It is considered part of any regular E/M encounter. > Therefore for a routine physical, you use the appropriate Preventive > Health code (99384-99387 for New patients, 99394-99397 for > Established patients). see Making Sense of Preventive Medicine Coding > - http://www.aafp.org/fpm/20040400/49maki.html > > If a Pap is done separately from a preventive exam, then you would use > the appropriate E/M outpatient visit code (99202-99205 for New, > 99212-99215 for Established). see Coding and Documentation: Coding Pap > smears - http://www.aafp.org/fpm/20010900/coding.html > > For Medicare patients, Medicare does not cover routine preventive > visits (except for an Initial Preventive Physical Exam for newly > enrolled Medicare beneficiaries and must be completed within 6 months > after Part B coverage begins) but it does pay for collection of a Pap > smear (once every 2 years for low risk, annually for high risk) using > the HCPCS code Q0091, and for the screening pelvic and breast exam > using the code G0101. This website also gives the appropriate ICD9 > codes to use: http://www.oknmmedicare.com/provider/reference/ > premedquickref.htm > > If you use these Medicare codes with an E/M code, you also need to add > the -25 modifier to the E/M code as a significant and separately > identifiable service. The CPT code 88142 is for " Cytopathology, > cervical or vaginal (any reporting system), collected in preservative > fluid, automated thin layer preparation; manual screening under > physician supervision " and is a laboratory charge. > > Seto > South Pasadena, CA > > > >> RE Billing for procedure >> >> 1) Fee for examination. >> 2) Fee for " collection service. " >> >> Not sure how well I get paid for this, though, as I haven't really >> done >> enough PAPs lately to track such EOBs, AND... I have a billing >> service (!) >> who usually scrubs alot of these claims for me (yes, my added >> expense, but >> it helps me). >> >> But, this is the main way of doing things... >> >> Dr Matt Levin >> Pittsburgh, PA >> PAPs/pathology >> >> >> > Ok- now I'm really confused. Medicare reimburses $47 for code G0101 >> (cervical or vaginal cancer screening; pelvic and clinical breast >> exam). Then there is code 88142 (cytopathology, cervical or >> > vaginal...manual screening under physician supervision). Is that >> the >> > code the pathology lab charges? I ask because I have seen other >> office superbills with this CPT code, when all they are doing is >> collecting the specimen, not performing the actually cytology. So I >> had come to think that it simply meant reviewing the report. >> > >> > >> > >> > >> > >> > >> > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 2, 2006 Report Share Posted May 2, 2006 , Your posts are so informative. Thank you for the effort you consistently put in to find useful information and share it in an organized fashion. When I grow up, I want to be just like you! Tim > , > It took me a while to figure out how to charge for Paps. My > understanding is that there is no CPT code for performing/collecting a > Pap smear. It is considered part of any regular E/M encounter. > Therefore for a routine physical, you use the appropriate Preventive > Health code (99384-99387 for New patients, 99394-99397 for > Established patients). see Making Sense of Preventive Medicine Coding > - http://www.aafp.org/fpm/20040400/49maki.html > > If a Pap is done separately from a preventive exam, then you would use > the appropriate E/M outpatient visit code (99202-99205 for New, > 99212-99215 for Established). see Coding and Documentation: Coding Pap > smears - http://www.aafp.org/fpm/20010900/coding.html > > For Medicare patients, Medicare does not cover routine preventive > visits (except for an Initial Preventive Physical Exam for newly > enrolled Medicare beneficiaries and must be completed within 6 months > after Part B coverage begins) but it does pay for collection of a Pap > smear (once every 2 years for low risk, annually for high risk) using > the HCPCS code Q0091, and for the screening pelvic and breast exam > using the code G0101. This website also gives the appropriate ICD9 > codes to use: http://www.oknmmedicare.com/provider/reference/ > premedquickref.htm > > If you use these Medicare codes with an E/M code, you also need to add > the -25 modifier to the E/M code as a significant and separately > identifiable service. The CPT code 88142 is for " Cytopathology, > cervical or vaginal (any reporting system), collected in preservative > fluid, automated thin layer preparation; manual screening under > physician supervision " and is a laboratory charge. > > Seto > South Pasadena, CA > > > >> RE Billing for procedure >> >> 1) Fee for examination. >> 2) Fee for " collection service. " >> >> Not sure how well I get paid for this, though, as I haven't really >> done >> enough PAPs lately to track such EOBs, AND... I have a billing >> service (!) >> who usually scrubs alot of these claims for me (yes, my added >> expense, but >> it helps me). >> >> But, this is the main way of doing things... >> >> Dr Matt Levin >> Pittsburgh, PA >> PAPs/pathology >> >> >> > Ok- now I'm really confused. Medicare reimburses $47 for code G0101 >> (cervical or vaginal cancer screening; pelvic and clinical breast >> exam). Then there is code 88142 (cytopathology, cervical or >> > vaginal...manual screening under physician supervision). Is that >> the >> > code the pathology lab charges? I ask because I have seen other >> office superbills with this CPT code, when all they are doing is >> collecting the specimen, not performing the actually cytology. So I >> had come to think that it simply meant reviewing the report. >> > >> > >> > >> > >> > >> > >> > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 5, 2006 Report Share Posted May 5, 2006 Suppose a gyn/pap exam is in addition to a follow up visit for an existing condition, let's say hypertension. Would it still be part of the E/M code for htn, or could you add a modifier? n Bobb-McKoySeto wrote: , It took me a while to figure out how to charge for Paps. My understanding is that there is no CPT code for performing/collecting a Pap smear. It is considered part of any regular E/M encounter. Therefore for a routine physical, you use the appropriate Preventive Health code (99384-99387 for New patients, 99394-99397 for Established patients). see Making Sense of Preventive Medicine Coding - http://www.aafp.org/fpm/20040400/49maki.html If a Pap is done separately from a preventive exam, then you would use the appropriate E/M outpatient visit code (99202-99205 for New, 99212-99215 for Established). see Coding and Documentation: Coding Pap smears - http://www.aafp.org/fpm/20010900/coding.html For Medicare patients, Medicare does not cover routine preventive visits (except for an Initial Preventive Physical Exam for newly enrolled Medicare beneficiaries and must be completed within 6 months after Part B coverage begins) but it does pay for collection of a Pap smear (once every 2 years for low risk, annually for high risk) using the HCPCS code Q0091, and for the screening pelvic and breast exam using the code G0101. This website also gives the appropriate ICD9 codes to use: http://www.oknmmedicare.com/provider/reference/premedquickref.htm If you use these Medicare codes with an E/M code, you also need to add the -25 modifier to the E/M code as a significant and separately identifiable service. The CPT code 88142 is for "Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision" and is a laboratory charge. Seto South Pasadena, CA RE Billing for procedure1) Fee for examination.2) Fee for "collection service."Not sure how well I get paid for this, though, as I haven't really done enough PAPs lately to track such EOBs, AND... I have a billing service (!) who usually scrubs alot of these claims for me (yes, my added expense, but it helps me).But, this is the main way of doing things...Dr Matt LevinPittsburgh, PA PAPs/pathology> Ok- now I'm really confused. Medicare reimburses $47 for code G0101> (cervical or vaginal cancer screening; pelvic and clinical breast> exam). Then there is code 88142 (cytopathology, cervical or> vaginal...manual screening under physician supervision). Is that the> code the pathology lab charges? I ask because I have seen other> office superbills with this CPT code, when all they are doing is> collecting the specimen, not performing the actually cytology. So I> had come to think that it simply meant reviewing the report.>>>>>>> Quote Link to comment Share on other sites More sharing options...
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