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Screening for Cervical Cancer with Human Papillomavirus (HPV) Tests

Human Papillomavirus 

The lab analyst performs the technical steps to detect human papillomavirus through nucleic acid detection and the Nucleic acid probes permit identification of microorganisms based on their DNA or RNA. 

The Nucleic acid quantitation allows assessment of treatment response and the Quantitation refers to measuring the exact amount of a substance. The lab analyst performs this procedure for detection of high risk types of human papillomavirus.

 HCPCS/CPT Codes

  • G0476 – Infectious agent detection by nucleic acid (DNA or RNA); human papillomavirus (HPV), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be performed in addition to pap test 

ICD-10 Codes

The specified below ICD codes are covered for CPT G0476 but may not be limited and some private payers having specific guidelines.

  • B97.7 Papillomavirus as the cause of diseases classified elsewhere
  • R85.81 Anal high risk human papillomavirus (HPV) DNA test positive
  • R85.82 Anal low risk human papillomavirus (HPV) DNA test positive
  • R87.810 Cervical high risk human papillomavirus (HPV) DNA test positive
  • R87.811 Vaginal high risk human papillomavirus (HPV) DNA test positive
  • R87.820 Cervical low risk human papillomavirus (HPV) DNA test positive
  • R87.821 Vaginal low risk human papillomavirus (HPV) DNA test positive
  • Z01.411 Encounter for gynecological examination (general) (routine) with abnormal findings
  • Z01.419 Encounter for gynecological examination (general) (routine) without abnormal findings
  • Z01.42 Encounter for cervical smear to confirm findings of recent normal smear following initial abnormal smear
  • Z11.51 Encounter for screening for human papillomavirus (HPV)
  • Z86.002 Personal history of in-situ neoplasm of other and unspecified genital organs

Who Is Covered

  • All asymptomatic female Medicare beneficiaries aged 30 to 65 years

Frequency

  • Once every 5 years

Medicare Beneficiary Pays

  • Copayment/coinsurance waived
  • Deductible waived

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