EM Coding for Pap Smear
For specimen collection and handling of a Pap smear, use CPT code G0101 for the cervical/vaginal cytology screening, Q0091 for the screening Papanicolaou smear, and 99000 for specimen handling. 1
Primary CPT Codes for Pap Smear Collection
The appropriate coding depends on the specific service being billed:
- G0101: Cervical or vaginal cancer screening; pelvic and clinical breast examination 1
- Q0091: Screening Papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory 1
- 99000: Handling and/or conveyance of specimen for transfer from the office to a laboratory 1
The pelvic examination itself is coded separately and is not included in the Pap smear code. 1 This is a critical distinction—the collection of the specimen and the physical examination are distinct billable services.
Medicare-Specific HCPCS Codes
For Medicare patients, use the following HCPCS codes: 1
- G0123: Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision
- G0124: Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, requiring interpretation by physician
- G0141-G0148: Various codes for conventional Pap smear screening and interpretation
Laboratory Interpretation Codes
The laboratory interpretation is billed separately from specimen collection. The pathology codes for cytology interpretation are distinct from the collection codes and should be billed by the laboratory, not the collecting provider. 1
Important Coding Considerations
Medicare covers screening at 3-year intervals for average-risk women, or yearly for high-risk women (those with history of cervical cancer, HIV infection, immunosuppression, or DES exposure). 1 This frequency limitation affects reimbursement eligibility.
The screening guidelines that inform appropriate use are: 2
- Ages 21-29: Pap test alone every 3 years
- Ages 30-65: Co-testing (Pap + HPV) every 5 years preferred, or Pap alone every 3 years
- Over age 65: Discontinue if adequate prior screening