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Preventive Services: Screening for Cervical Cancer with Human Papillomavirus (HPV) Tests

By:  Find-A-Code
Published:  September 1st, 2017

The following information from the Medicare Learning Network provides guidance from the Department of Health and Human Services on Screening for Cervical Cancer with Human Papillomavirus (HPV) Tests: 

HCPCS/CPT Codes

G0476 - Infectious agent detection by nucleic acid (DNA or RNA); human papillomavirus (HPV), high-risk types (e.g., 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

Z11.51 and either Z01.411 or Z01.419

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

 Other Notes


Please note: The information in this educational product applies only to the Medicare Fee-For-Service Program (also known as Original Medicare). For additional guidance on using diagnosis codes, go to the Medicare Claims Processing Manual, Chapter 18 on the Centers for Medicare & Medicaid Services (CMS) website.

Watch the CMS Provider Minute: Preventive Services video for pointers to help you submit sufficient documentation when billing for certain preventive services.


References:

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