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Official Description

Screening papanicolaou smear, cervical or vaginal, up to three smears, requiring interpretation by physician
Short Descr Screening pap smear by phys
Coverage Special coverage instructions apply
Pricing Indicator(s) 11 – Physician Fee Schedule - Price established using national RVUs
MPI C – Physician interpretation of clinical lab service is priced under physician fee schedule using RVUs, while pricing of lab service is paid under clinical lab fee schedule
CIM 50-20
Lab Cert(s) 630 – Cytology
Processing Note SEE INTERMEDIARY MANUAL 3628.1A FOR PAYMENT INSTRUCTIONS. (
BETOS T1G – Lab tests - other (Medicare fee schedule)
TOS Code(s) 5 – Diagnostic laboratory
Added Date 1/1/1992
Status Code Active Code
Global Days XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 0 - No payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Code Not Recognized by OPPS when submitted on Outpatient Hospital Part B Bill Type (12x/13x)
MUE 1
MUE Not applicable/unspecified.
IOM 100-03, 3, 190.2
OTS Orthotic No
CCS Clinical Classification 234 - Pathology
GA Waiver of liability statement issued as required by payer policy, individual case
X5 Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician
Date
Action
Notes
1992-01-01 Added Code added 1/1/1992
Code
Description
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