Your CPT Questions

Reprinted from August 1999 CAP TODAY

Q: Should Pap smears screened by a pathologist instead of a cytotechnologist be coded 88141?

A: No. It would be inappropriate to use code 88141, Cytopathology, cervical or vaginal (any reporting system); requiring interpretation by physician (List separately in addition to code for technical service), for screening Pap smears. The College advised in the February issue of CAP TODAY that, “Considering the interpretation code terminology and the CLIA requirements, negative Pap smears that do not require a physician’s interpretation, including smears reviewed for quality control purposes, should not be coded with the physician interpretation code.”

Although a pathologist may perform Pap smear screenings, not all those screenings will require physician interpretation. The pathologist must use the appropriate screening code for the service performed-88142, 88150, or 88164, for example. If a smear is abnormal (shows suspicious or malignant cells, epithelial cell abnormality, or cellular changes simulating epithelial cell abnormality such as repair, radiation effect, and cellular changes associated with viral infection), the pathologist may report the appropriate code for the screening and also use 88141 for the interpretation of the smear.

Q: I heard the Food and Drug Administration approved the AutoCyte PREP System in June. Which code should I use to report Pap smears prepared with this system?

A: The AutoCyte PREP System is a liquid-based sample preparation system that automatically prepares a sample by centrifugation through a liquid density reagent and stains cytology slides.

The FDA approved the PREP System for use in primary screening for cervical cancer. Pap smears prepared using this system should be coded using the appropriate code from the 88142 family (Cytopathology, cervical or vaginal [any reporting system], collected in preservation fluid, automated thin layer preparation;).

Use 88142 if only a manual screening is performed; 88143 if a manual screening and rescreening are performed; 88144 if a manual screening and computer-assisted rescreening are performed; or 88145 if a manual screening and computer-assisted rescreening using cell selection and review are performed.

The codes and descriptions listed here are from Current Procedural Terminology, a copyrighted publication of the American Medical Association. To purchase CPT books, call the AMA at (800) 621-8335.