Screening for Cervical Cancer

https://www.uhcprovider.com/content/dam/provider/docs/public/policies/comm-medical-drug/preventive-care-services.pdf

Service:

HRSA: Health Resources and Services Administration

HRSA Requirement:

Recommends cervical cancer screening for average-risk women aged 21 to 65 years. For women aged 21 to 29 years recommends cervical cancer screening using cervical cytology (Pap Test) every 3 years.

Co-testing with cytology and humana papillomavirus testing is not recommended for women younger than 30 years old. Women aged 30 to 65 years should be screened with cytology and human papillomavirus testing every 5 years or cytology alone every 3 years. Women who are at average risk should not be screened more than once every 3 years.

Procedure Code(s):

Humana Papillomavirus DNA Testing (HPV):

0502U, 87624, 87625, 87626, G0476

Cervical Cytology (Pap Test)

Code Group 1 Procedure Code(s):

G0101, G0123, G0124, G0141, G0143, G0144, G0145, G0147, G0148, Q0091, P3000, P3001

Code Group 2 Procedure Code(s):

88141, 88142, 88143, 88147, 88148, 88150, 88152, 88153, 88155, 88164, 88165, 88166, 88167, 88174, 88175

Diagnosis Codes(s):

Code Group 1 Diagnosis Code(s): Does not have diagnosis code requirements for preventive benefit to apply.

Code Group 2 Diagnosis Code(s):

Z00.00, Z00.01, Z01.411, Z01.419, Z12.4

Preventive Benefit Instructions:

Human Papillomavirus DNA Testing (HPV):

• Age 30 years and up.

• Requires one of the diagnosis codes listed above.

Cervical Cytology (Pap Test):

Code Group 1:

• Limited to age 21-65 years (ends on 66th birthday)

• Does not have diagnosis code requirements for preventive benefits to apply.

Code Group 2:

• Limited to age 21-65 years (ends on 66th birthday)

• Requires one of the Code Group 2 diagnosis codes listed above.