Learn New Guidelines for Cervical Cancer Screening

The Coding Institute LLC, 2222 Sedwick Road, Durham, NC 27713, Eenterprise Contact: Sam Nair, Direct: 704 303 8150,

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Learn New Guidelines for Cervical Cancer Screening By Susan Dooley

The practice of getting a Papanicolaou (Pap) smear at least every two years to screen for cervical cancer

was part of womens healthcare for generations. Now, however, cervical cancer screening guidelines

recommend less frequent testing, plus combining that testing with an HPV test, following the advice of

professional organizations including the American Society for Clinical Pathology (ASCP), American

Society for Colposcopy and Cervical Pathology (ASCCP), American College of Obstetricians and

Gynecologists (ACOG), American Cancer Society (ACS), and the U.S. Preventative Services Task Force

(USPSTF).

How Often Do Women Need Pap Tests?

These agencies agree that women aged between 21 and 65 years should have Pap testing once every

three years. For women aged 30 through 65 years, these experts recommend a Pap test combined with

human papillomavirus (HPV) test once every five years, instead of just a Pap test once every three years.

As great as the HPV test is, however, its not considered useful in women younger than 30. Its also not

advised as a standalone test at any age for cervical cancer screeningthe Pap test is still best for that.


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Screening Makes a Difference and Props to Dr. Pap

Did you know that in the 1940s, cervical cancer was the number one cause of death for women? I found

that surprising too. But soon after Dr. George Papanicolaou introduced his eponymous test in the 1940s,

cervical cancer deaths steadily trended downward. Today, according to the CDC, about 12,000 U.S.

women a year get cervical cancer and almost 4,000 women die from it. But thanks to regular screening

tests like the Pap and HPV, cervical cancer is the most preventable female cancer there is.

HPV Infection? Isnt That Just for Dirty People?

Human papillomavirus is at least as prevalent in humanity as the common cold. According to Cancer

Research UK, most humans will be infected with some form of HPV during their lifetimes. There are

more than 100 types of HPV, and most of them cause no symptoms. Others cause ugly but harmless skin

warts. By the way, HPV is just as common in men as in women, according to the CDC, but as yet there

are no tests to detect it in males. But according to the Centers for Disease Control (CDC), certain types of

HPV can cause normal cells on the uterine cervix to become abnormal, and over many years, these

abnormal cells can develop into cancer without treatment.

The reason that HPV tests arent recommended for screening in younger women and teens is related to

this abundance of HPV among humans. In fact, this virus is very common in men and women younger

than age 30. But most types of HPV will not cause health problems, and besides, people who contract

HPV usually fight it off quickly. However, HPV is less common in people older than 30. The viruss

presence in them can signal a health problem. In these cases, the virus has been present in peoples

bodies for many years and has had a chance to cause cellular changes that could turn into cancer.

CMS Agrees, Will Pay for Beneficiaries HPV Screening

Last summer, CMS determined that the evidence is sufficient to add HPV testing once every five years

as a screening benefit for beneficiaries aged between 30 and 65, in conjunction with the Pap test. The

agency issued a national coverage determination in July announcing the new coverage guidelines.

How Does This Affect Coders?

Expect some private payers to follow CMSs recommendation and add HPV screening coverage of their

own. However, payers may also have increased the time between allowable Pap tests to follow the new

guidelines. Check with your payers to determine their coverage.


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When you need to report that youve performed these tests (not report for collecting the sample), youll

need some of these handy CPT codes:

87623, Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV),

low-risk types (eg, 6, 11, 42, 43, 44)

87624, Human Papillomavirus (HPV), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56,

58, 59, 68)

87625, Human Papillomavirus (HPV), types 16 and 18 only, includes type 45, if performed

How About You?

Has your practice been affected by these guideline changes? We love to hear from you!

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Contact Us:

Name: Sam Nair

Title: Associate Director Enterprise Practice

Email: [email protected]

Direct: 704 303 8150

Desk: 866 228 9252, Ext: 4813

The Coding Institute LLC, 2222 Sedwick Road, Durham, NC 27713

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Learn New Guidelines for Cervical Cancer Screening