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Test Name

Image-Guided Pap with Age-Based Screening with CT/NG, Trichomonas

CPT Code(s)

88175, 87624, 87491, 87591, 87625, 87661

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 (CPT code(s): 87491, 87591), and Trichomonas vaginalis ("trich" or TV), Qualitative TMA, Pap Vial (CPT code(s): 87661) will also be performed.

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). CT/NG RNA, TMA (CPT code(s): 87491, 87591), and TV, Qualitative TMA, Pap Vial (CPT code(s): 87661) will also be performed.

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). CT/NG RNA, TMA (CPT code(s): 87491, 87591), and TV, Qualitative TMA, Pap Vial (CPT code(s): 87661) will also be performed.

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/Trich: Transcription Mediated Amplification (TMA)

Clinical Significance

This new test code will perform like test code 91384 but will always add Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Trichomonas vaginalis ("trich" or TV) testing to the Pap. Specifically, testing will occur 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, CT/NG and TV 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. Additionally, CT/NG and TV 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. Additionally, CT/NG and TV will be performed.
• Patients falling outside of the above age ranges, or without a date of birth, will receive an Image-guided Pap. Additionally, CT/NG and TV will be performed.

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

Alternative Name(s)

Age-Based Pap Screening and CT/NG/Trich,Age Based Smart Codes Pap Screening,Smart Codes for Age-Based Pap Screens,Cervical Cancer Screening Age-Based w/ CT/NG/Trich,Smart Codes for Age Based Pap Screen,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.

91386
91386
91386
91386
91386
91386X
91386
91386
91386
91386
91386X
91386
91386
91386
91386
91386X
191386
91386
91386
Image-Guided Pap with Age-Based Screening with CT/NG, Trichomonas
91386