Christine Posted Wed 11th of February, 2015 22:56:01 PM
What CPT code is used for pap cases that fail the imager? 88142 or 88175 or 88175-52?
SuperCoder Answered Fri 13th of February, 2015 07:14:43 AM
As per my research on this question, CPT 88175 should be billed with 52 modifier. The laboratory facility can bill CPT 88175 with 52 modifier, if they performed manual screening of PAP smear and were intended to do the imagination too, but failed due to some technical reasons.
Christine Posted Fri 13th of February, 2015 09:45:31 AM
I was reading on previous posting here and found an answer that conflicts with this. I may be misinterpretting it. It is under the post "88172 and G0144".
Can you address the below also? We jsut wnat to bo 100% certain.
You should not bill a Pap smear if you’re not able to complete the service due to equipment failure. That means you shouldn’t bill it, even with modifier 52.
Regarding whether to use 88175 or G0144 – that’s payer specific. Medicare requires the G codes for Pap smears, but many private payers use the CPT codes.
88175 Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with screening by automated system and manual rescreening or review, 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
52 Reduced services
SuperCoder Answered Mon 16th of February, 2015 03:28:19 AM
Since it is a peculiar situation, we cannot report modifier 52 (Reduced services) for a diagnostic test that lab isn’t able to complete due to technical problems. For those cases, there is not a chargeable service.
In the mentioned case, assuming that automated thin layer preparation has been performed and manual screening was done, when the automated screen has been failed - CPT code 88142 should have been billed.
Please find below the Super Coder Publication to support the answer, Published on Fri, Feb 07, 2014