icd 10 code for pap smear result

by Mrs. Rowena Marquardt 10 min read

4) Vaginal Pap test (Z12. 72)Oct 12, 2017

What is the ICD-10 code for repeat Pap smear?

When the provider repeats a Pap smear because of an inadequate sample or abnormal results, you'll report a code from R87. 61- Abnormal cytological findings in specimens from cervix uteri.

What is the ICD-10 code for gynecological exam?

Z01.419411, Encounter for gynecological examination (general) (routine) with abnormal findings, or Z01. 419, Encounter for gynecological examination (general) (routine) without abnormal findings, may be used as the ICD-10-CM diagnosis code for the annual exam performed by an obstetrician–gynecologist.

What is the ICD-10 code for history of abnormal Pap smear?

Unspecified abnormal cytological findings in specimens from cervix uteri. R87. 619 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM R87.

What is the code for a Pap smear?

However, for a screening pap, the HCPCS code for obtaining the screening pap smear, Q0091 may be used. Although this is a HCPCS code developed by Medicare for Medicare patients, many commercial payers recognize the code.

What is the ICD 10 code for well woman exam?

Z01.419Encounter for gynecological examination (general) (routine) without abnormal findings. Z01. 419 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM Z01.

What is the ICD 10 code for cervical screening?

ICD-10 code Z12. 4 for Encounter for screening for malignant neoplasm of cervix is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .

How does Medicare code for Pap smear?

Medicare also pays for obtaining a screening pap smear, using code Q0091 with the same frequency requirements as above.

How do you code a repeat Pap smear?

You should use 795.0x (Nonspecific abnormal Papanicolaou smear of cervix) as the diagnosis code if the ob-gyn repeats the Pap smear due to abnormal results.

What is hx of abnormal Pap?

An abnormal Pap test result means there are cells on your cervix that don't look normal under a microscope. This fairly common condition is known as cervical dysplasia, or pre-invasive cervical disease.

How do you code a well woman exam?

Well Women Exam CPT Code CPT G0101 may be used to report Well Woman Exam. The description of the CPT code for Well woman is as follows: “Cervical or vaginal cancer screening; pelvic and clinical breast exam.”

What are preventive diagnosis codes?

“Routine” diagnosis codes are considered Preventive. For example: ICD-10-CM codes Z00. 121, Z00. 129, Z00.

What does diagnosis Z12 4 mean?

ICD-10 code: Z12. 4 Special screening examination for neoplasm of cervix.

What is the CPT code for gynecological exam?

The patient preventive medicine services codes 99381-99397 include an age- and gender-appropriate physical exam. According to CPT Assistant, performing a pelvic and breast exam, as well as obtaining a screening Pap smear, are all part of the comprehensive preventive service and should not be reported separately.

What is the CPT code for a well woman exam?

Well Women Exam CPT Code CPT G0101 may be used to report Well Woman Exam. The description of the CPT code for Well woman is as follows: “Cervical or vaginal cancer screening; pelvic and clinical breast exam.”

What is the Z34.82 code?

Encounter for supervision of other normal pregnancy, 2nd trimester (Z34.82) Encounter for supervision of other normal pregnancy, 3rd trimester (Z34.83) For supervision of a pregnancy that is not normal, we are instructed to utilize codes from Chapter 15, Pregnancy, Childbirth and Puerperium. These codes include:

Why do you need additional codes for a Pap?

If a vaginal Pap test or additional testing is being performed at the time of the Pap test, additional codes are necessary to support the medical necessity for each test.

When to use diagnostic code?

A diagnostic code should be used when there are signs or symptoms of disease. To help you determine if a Pap test was performed for diagnostic purposes, here are a few things to consider.

When did ICD-10 become effective?

New conditions have been discovered and many new treatments and medical devices have been developed. The ICD-10 code set that became effective on October 1, 2015, tries to capture the current practice of medicine and provide flexibility as it changes in the future. Provided below are some of the common issues that you may encounter ...

Zero In on R87.61- Subcategory

When the provider repeats a Pap smear because of an inadequate sample or abnormal results, you’ll report a code from R87.61- Abnormal cytological findings in specimens from cervix uteri.

Look Elsewhere for These Diagnoses

There’s an impressive list of Excludes1 and Excludes2 notes at the R87.61- level, meaning the list applies to all codes in that subcategory.

Know Which Code to Use for Inadequate Sample

Subcategory R87.61- has a lot of codes, so don’t miss two slightly different ones in the middle:

What is a Pap smear?

Pap smear during a preventive medicine services for a commercial patient. If the patient presents for a preventive medicine service , the pelvic exam is part of the age and gender appropriate physical exam, as described by CPT ® codes in the 99381—99397 series of codes.

What is the Medicare code for pelvic exam?

There is a HCPCS code for this, G0101.

Why not report Q0091?

Do not report Q0091 because it is for obtaining a screening test. Use G0101 and Q0091 for Medicare patients receiving a screening pelvic and breast exam and having a screening pap smear. There are frequency limits for this service. Applying the 2021 office visit guidelines is challenging.

What is the CPT code for a physical exam?

CPT codes 99381–99397 include an age and gender appropriate history and physical exam. Billing G0101 would be double billing for that portion of the exam. G0101 Cervical or vaginal cancer screening; pelvic and clinical breast examination (Ca screen; pelvic/breast exam )

Does Medicare pay for Pap smears?

Pap smear during a Medicare wellness visit. Medicare doesn’t pay for routine services, but does pay for a cervical/vaginal cancer screening with a breast exam. (Medicare pays for wellness visits, not discussed here.

Is pelvic exam part of E/M?

The pelvic exam that the provider does is part of the E/M service . There isn’t a code to separately bill the pelvic exam that is part of a problem-oriented visit. It would be incorrect to bill the HCPCS code Q0091 for obtaining a screening pap smear, because the purpose of the visit and the pap is not screening.

Who can use CPT code for pap smear?

The only CPT ® codes specifically for pap smears are for use by a pathologist, for the interpretation of the cytology specimen. CPT® codes in the lab section, 88000 series, should not be reported by the office physician who collects the pap smear. Those codes are used by the pathologist who provides the interpretation of the pap smear.

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