What is the billing code for the collection of a Pap (Papanicolaou) smear?

Billing Code for Collection of Pap Smear Only

The appropriate billing code for collection of a Pap smear specimen is $45.93 according to Medicare payment values. 1

Procedure Details and Coding

• Medicare's "National Payment Amount" for collection of a Pap smear specimen was established at $45.93 (as of 2013 data) 1
• This is distinct from the billing code for a screening pelvic examination, which was $38.11 1
• The Pap smear collection code specifically covers the procedure of obtaining the cervical specimen for cytological examination 1

Clinical Context for Pap Smear Collection

• Pap smear collection involves obtaining cells from the cervix for screening of cervical cancer and detection of human papillomavirus (HPV) 1
• The procedure should be limited to visual inspection of the cervix and cervical swabs for cancer and HPV detection 1
• Collection technique is critical for obtaining a quality specimen, with proper visualization of the cervix being essential 2, 3

Collection Methods and Best Practices

• The combination of Cytobrush (for endocervix) and spatula (for ectocervix) is superior for obtaining quality Pap smear specimens 3
• The Cervex-brush (broom) alone has been associated with higher rates of absent endocervical cells and unsatisfactory results 3
• Immediate wet fixation of the smear is crucial for reliable detection of precancerous lesions in conventional Pap smears 4
• For liquid-based preparations, the cells are transferred to a vial containing a weak fixative 4

Important Considerations

• The Pap smear should be collected before obtaining samples for other tests such as STI screening 2
• If mucopurulent discharge is present, it should be carefully removed with a saline-soaked cotton swab before obtaining the specimen 2
• Presence of infection can decrease the quality of the specimen 3
• The reliability of cervical cytology strongly depends on proper collection technique and immediate fixation 4

Billing Pitfalls to Avoid

• Do not confuse the Pap smear collection code ($45.93) with the screening pelvic examination code ($38.11) 1
• Ensure proper documentation of the procedure to support the billing code 1
• Be aware that the total annual cost of preventive gynecologic examinations and associated laboratory and radiologic services in the United States is estimated to be $2.6 billion, with a significant portion potentially spent on unnecessary procedures 1