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Test Name

Image-Guided Pap with Age-Based Screening Protocols

CPT Code(s)

88175, 87624, 87491, 87591, 87625

Includes

Patients 21-25: If the Pap result is ASC-US then the HPV mRNA assay will be performed at an additional charge (CPT code(s): 87624). Chlamydia trachomatis (CT)/Neisseria gonorrhoeae (NG) RNA, TMA will also be performed (CPT code(s): 87491, 87591).

Patients 26-29: If the Pap result is ASC-US then the HPV mRNA assay will be performed at an additional charge (CPT code(s): 87624).

Patients 30-65: If the Pap result is negative and the HPV mRNA screen (CPT code(s): 87624) is positive (detected), then HPV mRNA Genotypes 16, 18/45 will be performed at an additional charge (CPT code(s): 87625).

Pap results requiring physician interpretation will be performed at an additional charge (CPT Code(s): 88141; HCPCS: G0124).

Methodology

Pap: Microscopy with Computer-imaging
HPV/CT/NG: Transcription Mediated Amplification (TMA)

Clinical Significance

This new test code is designed to help clinicians order age-appropriate testing for cervical cancer screening and STIs. Based on the patient's age and on ACOG Practice Guidelines for cervical cancer screening and Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) screening, testing in addition to the Pap will be processed as follows:

• Patients aged 21-25: Patients will receive Image-guided Pap and, when the result is ASC-US, a high-risk HPV mRNA test will be performed. Additionally, testing for CT/NG will be performed.
• Patients aged 26-29: Patients will receive Image-guided Pap and, when the result is ASC-US, a high-risk HPV mRNA test will be performed.
• Patients aged 30-65: Patients will receive Image-guided Pap and a high-risk HPV mRNA test. When the Pap result is negative but the HPV mRNA screen is positive, Genotyping for HPV mRNA 16, 18/45 will be performed.
• Patients falling outside of the above age ranges, or without a date of birth, will receive an Image-guided Pap only.

Codes may include ThinPrep® or SurePath™ Image-guided Paps, HPV mRNA, CT/NG.

Alternative Name(s)

Age Based Pap Screening Protocol,Age Based Smart Codes Pap Screening,Smart Codes for Age-Based Pap Screens,Smart Codes for Age Based Pap Screen,Age-Based Pap Screening,Cervical Cancer Screening Protocol, Age-Based,Age-Based Smart Codes Pap Screening

To view specimen requirements and codes please Select a regional laboratory.

Not sure which laboratory serves your office? Call us 866-MYQUEST (866-697-8378)

Reference ranges are provided as general guidance only. To interpret test results use the reference range in the laboratory report.

The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

* The tests listed by specialist are a select group of tests offered. For a complete list of Quest Diagnostics tests, please refer to our Directory of Services.

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Image-Guided Pap with Age-Based Screening Protocols
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