Preventive Services: Screening Pelvic Examinations

by  Find-A-Code
September 1st, 2017

The following information from the Medicare Learning Network provides guidance from the Department of Health and Human Services on Screening Pelvic Examinations (includes a clinical breast examination): 


G0101 - Cervical or vaginal cancer screening; pelvic and clinical breast examination

ICD-10 Codes

High risk – Z77.29, Z77.9, Z91.89, Z92.89, Z72.51, Z72.52, and Z72.53

Low risk – Z01.411, Z01.419, Z12.4, Z12.72, Z12.79, and Z12.89

Current codes are listed in the ICD-10 Conversion/Coding Infrastructure Revisions to National Coverage Determinations (NCDs)--3rd Maintenance CR9252. The Medicare Claims Processing Manual, Chapter 18, Section 40.4 is pending an update to correct this information.

Who Is Covered

All female Medicare beneficiaries


  • Annually if at high risk for developing cervical or vaginal cancer or childbearing age with abnormal Pap test within past 3 years
  • Every 2 years for women at normal risk

Medicare Beneficiary Pays

  • Copayment/coinsurance waived
  • Deductible waived

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.


Preventive Services: Screening Pelvic Examinations. (2017, September 1). Find-A-Code Articles. Retrieved from

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