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Preventive Services: Screening Pap Tests

By:  Find-A-Code
Published:  September 1st, 2017

The following information from the Medicare Learning Network provides guidance from the Department of Health and Human Services on Screening Pap Tests: 

HCPCS/CPT Codes

G0123 - Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision
G0124 - Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, requiring interpretation by physician
G0141 Screening cytopathology smears, cervical or vaginal, performed by automated system, with manual rescreening, requiring interpretation by physician
G0143 - Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under physician supervision
G0144 - Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervision
G0145 - Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision
G0147 Screening cytopathology smears, cervical or vaginal, performed by automated system under physician supervision
G0148 - Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening
P3000 - Screening Papanicolaou smear, cervical or vaginal, up to three smears, by technician under physician supervision
P3001 Screening Papanicolaou smear, cervical or vaginal, up to three smears, requiring interpretation by physician
Q0091 - Screening Papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory

ICD-10 Codes

High risk – Z72.51, Z72.52, Z72.53, Z77.29, Z77.9, Z91.89, and Z92.89

Low risk – Z01.411, Z01.419, Z12.4, Z12.72, Z12.79, and Z12.89

Who Is Covered

All female Medicare beneficiaries

Frequency

  • Annually if at high risk for developing cervical or vaginal cancer or childbearing age with abnormal Pap test within past 3 years
  • Every 2 years for women at normal risk

Medicare Beneficiary Pays

  • Copayment/coinsurance waived
  • Deductible waived

Please note: The information in this educational product applies only to the Medicare Fee-For-Service Program (also known as Original Medicare). For additional guidance on using diagnosis codes, go to the Medicare Claims Processing Manual, Chapter 18 on the Centers for Medicare & Medicaid Services (CMS) website.

Watch the CMS Provider Minute: Preventive Services video for pointers to help you submit sufficient documentation when billing for certain preventive services.


References:

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