More than 13,000 women in the United States are diagnosed with invasive cervical cancer each year. However, vaccination and appropriate screening can help prevent this disease and increase the rate of early detection. There is no single solution to ending cervical cancer, but together, we can help close gaps in care for our members.
Steps for closing care gaps:
- Use the Gap in Care report to identify patients who need to be scheduled for a wellness visit or to identify patients who are not compliant for this measure. To see who is noncompliant, filter for measure name and ‘noncompliant’ using the ‘Compliant Status’ column.
- During the visit:
- Highlight the importance of early detection.
- Review barriers.
- Stress importance of yearly screening.
- Place reminders in patients’ charts for when their next screening is due and make reminder calls for scheduling follow-up calls and visits.
- Flag the patient’s chart after screening is performed to ensure the data is captured for compliance and timely follow-up of the results takes place.
- Ask to have cervical cytology results sent to you if they are done at an OB/GYN office.
See EmblemHealth Clinical Practice Guidelines and the latest guidance from the American Cancer Society that was just released Dec. 4, 2025.
Actions needed for compliance:
Cervical cancer screening for women 21 to 64 years of age, following the required timeframe:
- Women 21 to 64 years of age: Cervical cytology during the current year or two years prior to the current year (every three years).
- Women 30 to 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 to 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 and 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.