There is a discussion going on in my office about the use of the 8875 pap smear lab code.
We are a gyn office and we also have an independent lab under the same company using different tax id and NPI number.
When we do annual gyn exams for Medicare patients only we bill out the Q0091 and the G0101. We also do a pap smear 88175 using the annual exam ICD10 code Z01.411 or Z01.419. They are being denied. There is an ICD 10 code that when used is paying and that is the Z12.4. In looking at the ICD 10 code it clearly states that it
excludes (when screening is part of general gynecological examination (Z01.4-).
The lab manager feels that we should go ahead and use Z12.4 because it also gives the description of (Encounter for screening for malignant neoplasm of cervix).
Is it appropriate to use the Z12.4 code for purpose of the annual gyn exam?
Why does this code also state the reason for usage when we are doing a screening?
Does the physician use Z12.4 for a different reason and if so, what would that be?
I understand that the Medicare Preventative Chart shows that for Pap screening we could use G0143. We could also use the appropriate ICD 10 code Z01.411 or Z01.419 and it will pay. The problem is that it pays half the price of using the 88175.
What is the right way of doing this?
We are a gyn office and we also have an independent lab under the same company using different tax id and NPI number.
When we do annual gyn exams for Medicare patients only we bill out the Q0091 and the G0101. We also do a pap smear 88175 using the annual exam ICD10 code Z01.411 or Z01.419. They are being denied. There is an ICD 10 code that when used is paying and that is the Z12.4. In looking at the ICD 10 code it clearly states that it
excludes (when screening is part of general gynecological examination (Z01.4-).
The lab manager feels that we should go ahead and use Z12.4 because it also gives the description of (Encounter for screening for malignant neoplasm of cervix).
Is it appropriate to use the Z12.4 code for purpose of the annual gyn exam?
Why does this code also state the reason for usage when we are doing a screening?
Does the physician use Z12.4 for a different reason and if so, what would that be?
I understand that the Medicare Preventative Chart shows that for Pap screening we could use G0143. We could also use the appropriate ICD 10 code Z01.411 or Z01.419 and it will pay. The problem is that it pays half the price of using the 88175.
What is the right way of doing this?