What is the diagnosis code for Pap smear?
Z12.4 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2021 edition of ICD-10-CM Z12.4 became effective on October 1, 2020. This is the American ICD-10-CM version of Z12.4 - other international versions of ICD-10 Z12.4 may differ.
What is the procedure code for Pap smear?
- Inspection and palpation of breasts for masses or lumps, tenderness, symmetry, or nipple discharge
- Digital rectal examination including sphincter tone, presence of hemorrhoids, and rectal masses
- External genitalia
- Urethral meatus
- Urethra
- Bladder
- Vagina
- Cervix
- Uterus
- Adnexa/parametria
What is the diagnosis code for cancer screening?
These services require dual diagnosis codes. The primary International Statistical Classification of Diseases and Related Health Problems, 10th revision, (ICD-10) code Z11.51 must be reported along with one of the following secondary ICD-10-CM diagnosis codes: Z01.411 or Z01.419.
What is the ICD 10 code for Pap smear?
- Abnormal cervical Papanicolaou smear
- Abnormal cervical Papanicolaou smear with positive human papillomavirus deoxyribonucleic acid test
- Abnormal cervical smear
- Atypical endocervical cells on cervical Papanicolaou smear
- Cannot exclude glandular neoplasia on cervical smear
- Cervical smear - atrophic changes
- Cervical smear - borderline changes
What is the ICD-10 code for Pap smear?
Vaginal Pap test (Z12. 72)
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.
What is the ICD-10 code for cervical cancer 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 .
What is the ICD-10 code for routine annual gynecological visit and exam with Pap smear?
411, 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.
Are Pap smears covered by Medicare?
Medicare covers most of the cost of a Cervical Screening Test, so if your chosen cervical screening doctor offers 'bulk billing', there should be no cost to you for the test.
How do you bill for a Pap smear only?
If a physician performs a Pap Smear (obtaining the specimen, preparing the slide, and conveyance - Q0091) and an unrelated, separately identifiable E/M on the same day both services may be billed. The appropriate medical E/M office visit code (99202-99215) may be reported with modifier 25 in addition to Q0091.
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.
What is the ICD-10 code for annual physical exam?
Z00.00ICD-10 Code for Encounter for general adult medical examination without abnormal findings- Z00. 00- Codify by AAPC.
What does code Z12 11 mean?
A screening colonoscopy should be reported with the following International Classification of Diseases, 10th edition (ICD-10) codes: Z12. 11: Encounter for screening for malignant neoplasm of the colon.
Is a Pap smear part of a physical?
The annual exam is done to check your overall physical health. The Pap smear screens for cervical cancer. A Pap smear may be offered as part of an annual exam. If you have a cervix and have ever been sexually active in any way, you need regular pap smears.
What is the ICD 10 code for annual wellness visit?
An initial Annual Wellness Visit code is documented using G0438, subsequent Annual Wellness Visits are documented using code G0439.
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.
Does Medicare cover Pap?
Medicare Part B covers screening Pap tests and pelvic exams (including clinical breast exam) for all female patients when ordered and performed by 1 of these medical professionals, as authorized under state law:
Is CPT copyrighted?
CPT codes, descriptions and other data only are copyright 2020 American Medical Association. All Rights Reserved. Applicable FARS/HHSAR apply. CPT is a registered trademark of the American Medical Association. Applicable FARS/HHSAR Restrictions Apply to Government Use. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.
What is the CPT code for a Pap smear?
Use following CPT codes for Diagnostic Pap smear billing and coding. 88141-88143.
Does Medicare cover a Pap smear?
Medicare provides coverage for both screening and Diagnostic Pap smear and correct way of billing and coding Pap smear depend upon choosing the right CPT code for Diagnostic and screening pap smear. A cervical screening test (previously known as a smear test) is a method of detecting abnormal cells on the cervix.
General Information
CPT codes, descriptions and other data only are copyright 2020 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.
CMS National Coverage Policy
Title XVIII of the Social Security Act, Section 1833 (e) states that no payment shall be made to any provider of services or other person under this part unless there has been furnished such information as may be necessary in order to determine the amounts due such provider or other person under this part for the period with respect to which the amounts are being paid or for any prior period..
Article Guidance
It has come to our attention that services submitted for screening for cervical cancer with Human Papillomavirus (HPV) Testing have been reported incorrectly. This Billing and Coding Article provides billing and coding guidance for these services.
ICD-10-CM Codes that Support Medical Necessity
It is the provider’s responsibility to select codes carried out to the highest level of specificity and selected from the ICD-10-CM code book appropriate to the year in which the service is rendered for the claim (s) submitted.
ICD-10-CM Codes that DO NOT Support Medical Necessity
All those not listed under the “ICD-10 Codes that Support Medical Necessity” section of this article.
Bill Type Codes
Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type.
Revenue Codes
Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination.
