Screening Pap Smear FAQs

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  1. When billing a screening pap smear, which diagnosis is required to indicate that a patient is considered high risk?
  1. When billing a screening pap smear, which diagnosis is required to indicate that a patient is considered high risk?

    When billing a screening pap smear for a high risk beneficiary, providers must make sure that the high risk diagnosis code of V15.89 is used.

    Providers should use one of the following diagnosis codes to indicate a patient is considered at low risk:

    V76.47
    V76.49

    V72.31
    Special screening for malignant neoplasm, vagina NOTE: providers use this diagnosis for women without a cervix.
    Routine gynecological examination
    NOTE: This diagnosis should only be used when the provider performs a full gynecological examination.

    For complete details please refer to the Internet Only Manual (IOM) Publication 100-04 Medicare Claims Processing ManualAdobe Portable Document format, Chapter 18 Section 30.6 located on the CMS website.

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Page Last Updated: Wednesday, 14-Dec-2011 16:46:04 CST