Pap Test Coding

Medicare requires that the reason for Pap testing be provided for reimbursement purposes. Three categories are preprinted on our Cytology Requisition Forms for your convenience. They are as follows:

  • Diagnostic Pap Test
    You must include the ICD 9 code for one of the following:
    • Previous cancer of cervix, uterus, or vagina
    • Abnormal Pap test
    • Any signs or symptoms determined by the physician, which reasonably might be associated with a gynecologic disorder
  • Screening Pap / High Risk
    Defined by Medicare as:
    • Onset of sexual activity before 16 years of age
    • Five or more sexual partners in a lifetime
    • History of sexually transmitted disease
    • Fewer than 3 negative Pap tests in the past seven years
    • Daughter of mother who took diethylstilbestrol (DES) during pregnancy
  • Screening Pap / Low Risk
    All others

HPV Testing

It has also come to our attention that this same information is needed when HPV testing is done from the ThinPrep vial.

Therefore, this information needs to be provided to us on all Medicare patients and any patient receiving HPV testing (Low or High Risk). Providing this information will assist your patient in receiving the proper reimbursement from her insurance provider.

Your assistance is greatly appreciated. If you have any questions, please contact our Client Service Representative, Denise Guy, at 843-503-5442.