The American Cancer Society estimates that more than 13,000 new cases of invasive cervical cancer will have been diagnosed in the United States in 2024. More than 4,000 women will die from cervical cancer.
There’s no single, simple solution to ending cervical cancer, but the disease is preventable with vaccination and appropriate screening.
January is Cervical Health Awareness Month, so you may find it useful to leverage awareness of this recognition month to foster a conversation with your patients about the importance of screening.
Cervical Cancer screening is a quality measure and is included in our Quality Measures Resource Guide.* The resource guide provides details of quality measures, descriptions of documentation/coding, best practices, and steps to close care gaps.
Who is included in the measure?
Women 21 – 64 years of age who had a proper screening for cervical cancer in the required time frame.
Actions needed for compliance
Cervical cancer screening for women 21 – 64 years of age, following the required time frame:
Women 21 – 64 years of age: Cervical cytology during the current year or two years prior to the current year (every three years).
Women 30 – 64 years of age: Cervical high-risk human papillomavirus (hrHPV) testing performed during the current year or four years prior to the current year (every five years).
Women 30 – 64 years of age: Cervical cytology/HPV co-testing during the current year or four years prior to the current year (every five years).
Documentation/coding requirements
Documentation of date (month, year) cervical cytology was performed and results or findings.
Use correct billing codes and ensure timely submission of claims:
Cervical cytology CPT: 88141 – 88143, 88147, 88148, 88150, 88152 – 88164 – 88167, 88174, 88175.
HCPCS: G0123, G0124, G0141, G0143, G0144, G0145, G0147, G0148, P3000, P3001, Q0091.
HPV test CPT: 87624, 87625.
HCPCS: G0476.
Steps for closing care gaps:
- Use the Gap in Care report to identify patients to schedule for a wellness visit, if not yet arranged. You can also use the Gap in Care report to identify patients who are not compliant for this measure. Filter for measure name and ‘non-compliant’ using the ‘Compliant Status’ column.
- During visit, highlight the importance of early detection, review barriers, and stress importance of yearly screening.
- Place reminders in patients’ charts for when next screening is due, and reminder calls for scheduling.
- Flag charts of patients after screening is performed to ensure timely follow-up of results and data capture for compliance.
- Request to have cervical cytology results sent to you if done at an OB/GYN office.
Learn more about cervical health awareness and prevention and other Quality tips at EmblemHealth.
*The information contained in the Quality Measures Resource Guide was compiled in November 2023 and is subject to change as the sources update their specifications. The 2025 version is coming soon. Measures included in this guide are sourced from the National Committee for Quality Assurance (NCQA) — ncqa.org, Centers for Medicare & Medicaid Services (CMS) — cms.gov, and New York State Department of Health (NYSDOH) — health.ny.gov. NCQA HEDIS® specifications and New York state Value Set Directory can be viewed at ncqa.org/hedis/measures. Please confirm with your EmblemHealth or ConnectiCare provider network representative that suggested codes are payable per your specific contract.
JP 67788 12/2024
