Reimbursement Advisor

Codes for new Pap follow-up test


 

Q What is the CPT code for the new PapSure exam (Watson Diagnostics, Inc, Corona, Calif)?

A PapSure, according to the company’s brochure, is a new visual cervical screening exam that is performed right after the Pap smear sample is collected. The physician first washes the cervix with a mild solution, then examines it visually using a small disposable blue light and a special magnifying lens. The blue light causes abnormal tissue to appear bright white, helping clinicians better detect possibly harmful abnormalities.

To my knowledge, no payers are covering this exam yet. A few of the practices I talked to are collecting directly from the patient, using the unlisted code 58999. This is because, until recently, there was no CPT code for the procedure. But in July 2002, CPT added two Category III codes to cover billing for this procedure: 0031T (speculoscopy) and 0032T (speculoscopy; with directed sampling).

Category III codes, to be used in place of the unlisted codes, are assigned to new technologies that either are not currently a standard of care or need more data to prove their efficacy. It is unlikely that payers will reimburse for this test at present, but 1 or 2 might consider it if you can negotiate the service.

This article was written by Melanie Witt, RN, CPC, MA, former program manager in the Department of Coding and Nomenclature at ACOG. She is now an independent coding and documentation consultant. Her comments reflect the most commonly accepted interpretations of CPT-4 and ICD-9-CM coding. When in doubt on a coding or billing matter, check with your individual payer.

OBG Management ©2003 Dowden Health Media

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