Reprinted from February 1999 CAP TODAY
The Health Care Financing Administration, responding to a new CPT coding
system for Pap smears, has told its payment contractors that seven alphanumeric
codes should be used to report services covered under the Medicare Pap
smear screening benefit.
In a recent program memorandum to carriers, HCFA said use of the HCFA
Common Procedure Coding System, or HCPCS codes (table
I) is important in being able to track screening and diagnostic Pap
smears and stay within statutory limits on how often Medicare can cover
the screening benefit period.
HCPCS codes are companions to the CPT codes, which HCFA says should be
used when a Pap smear is provided as a diagnostic service, that is, in
response to signs or symptoms of disease. Use of the HCPCS and CPT coding
scheme began Jan. 1.
In the memorandum, HCFA describes when to use both the alphanumeric codes
and their CPT companions (table
In the same notice, HCFA eliminated for use as cytotechnologist screening
codes two previously used alphanumeric codes, G0124 and P3001. They are
now to be used to report physician Pap smear interpretation services.
Providers and others also should note the deleted redundant codes and
their crosswalk to the 1999 codes (table
HCFA also established HCPCS codes for reporting the physician interpretation
of a Pap smear that should be used when the Pap smear originated as a
screening service. The alphanumeric codes are companions to the CPT codes
used for diagnostic Pap smear interpretations. Three alpha codes for physician
Pap smear interpretations of screening Pap smears are as follow:
cytopathology, cervical or vaginal (any reporting system), collected in
preservative fluid, automated thin layer preparation, requiring interpretation
cytopathology smears, cervical or vaginal, performed by automated system,
with manual rescreening, requiring interpretation by physician; and
Papanicolaou smear, cervical or vaginal, up to three smears, requiring
interpretation by physician.
HCFA deleted two previously used alphanumeric codes for physician interpretation,
G0124-26 and P3001-26.
The appropriate Medicare code for Pap smear interpretation is determined
by the reason for performing the test (screening or diagnostic), the methods
of specimen preparation and evaluation (screening), and reporting system
used, HCFA said (table
For a copy of the HCFA memorandum, visit the College’s Web site (www.cap.org)
under “Government Documents” in the site’s “Advocacy”