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Screening for cervical cancer and STIs, simplified

Smart Codes 
make it easy

 

Delivering the care your patients need should not be complicated. Smart Codes from Quest Diagnostics are based on guidelines and use a patient’s age and STI risk factors to determine which combination of HPV and select STI screening, along with an image-guided Pap, should be performed.

smiling female doctor with patient

Trust Smart Codes to order appropriate guidelines-based screening for your patients

Smart Codes are designed to align with current cervical cancer and STI screening guidance and help streamline age- and risk-based ordering.¹⁻⁴

Age- and risk-based screening protocols

HPV DNA testing detects high-risk viral DNA and provides individual HPV 16 and HPV 18 results, plus pooled results for 12 other high-risk genotypes.
 

Learn more >

Cervical cancer screening and average risk for STIs (CT/NG)2,3

When cervical cancer screening is the main reason for the visit, and your patient does not have any of the symptoms or at-risk behavior for STIs, consider code 20453. Guidelines recommend annual screening for Chlamydia trachomatis and Neisseria gonorrhoeae (CT/NG) in all sexually active women younger than 25 years.3
 

Tests include
Ages (years)20453
Automated Pap,a Cervical, with Age-Based Screen, HPV DNA
< 21

Automated Pap (ThinPrep® or SurePath™)

21–24
  • Automated Pap (ThinPrep or SurePath)
  •  High-risk HPV DNA (16, 18, other high risk) (if Pap is ASC-US)
  •  CT/NG
25–29
  • Automated Pap (ThinPrep or SurePath)
  • High-risk HPV DNA (16, 18, or other high risk) (if Pap is ASC-US or LSIL)
30–65

Pap and HPV together as co-testing

  • Automated Pap (ThinPrep or SurePath)
  • High-risk HPV DNA (16, 18, or other high risk)
65+Automated Pap (ThinPrep or SurePath)
Components of panels can be ordered separately.
Cervical cancer screening and high risk for STIs (CT/NG/Trich)1-3

When your patient needs routine cervical cancer screening and has symptoms or is at risk for an STI due to 
a partner’s behavior, consider 20519 or 20454.
 

Tests include
Ages (years)20519
Automated Pap,a cervical, with age-based screen, HPV DNA with CT/NG, Trichomonas		20454

Automated Pap,a cervical, with age-based screen, HPV DNA, with CT/NG
< 21

Same as 20453, plus CT/NG and Trichomonas

Same as 20453, plus CT/NG (guidelines recommend annual CT/NG screening for
all sexually active women younger than
25 years5)
21–24

Same as 20453, plus Trichomonas

Same as 20453
25–29

Same as 20453, plus CT/NG and Trichomonas

Same as 20453, plus CT/NG (guidelines recommend CT/NG screening for women 25 and older when they are at increased risk3)
30–65

Same as 20453, plus CT/NG and Trichomonas

Same as 20453, plus CT/NG (guidelines recommend CT/NG screening for women 25 and older when they are at increased risk3)
65+Same as 20453, plus CT/NG and TrichomonasSame as 20453, plus CT/NG (guidelines recommend CT/NG screening for women 25 and older when they are at increased risk3)

Components of panels can be ordered separately.

 

Components for HPV DNA Smart Codes 

ThinPrep Automated Pap (58315); SurePath™ Imaging Pap (18810); ThinPrep Automated Pap, reflex HPV DNA (when ASC-US) (18316); SurePath Automated Pap, reflex HPV DNA (when ASC-US) (18326); ThinPrep Automated Pap, reflex HPV mRNA (when ASCUS) (90934); SurePath Automated Pap, reflex HPV mRNA (when ASCUS) (18811); ThinPrep Automated Pap, reflex HPV DNA (when ASCUS or LSIL) (20451); SurePath Automated Pap, reflex HPV DNA (when ASCUS or LSIL) (20452); ThinPrep Automated Pap, reflex HPV mRNA (when ASCUS or LSIL) (20449); SurePath Automated Pap, reflex HPV mRNA (when ASCUS or LSIL) (20450); ThinPrep Automated Pap and HPV DNA (18313); SurePath Automated Pap and HPV DNA (18315); ThinPrep Automated Pap and HPV mRNA, reflex Genotyping (Pap -, HPV +) (91414); SurePath Automated Pap and HPV mRNA, reflex Genotyping (Pap -, HPV +) (18829); HPV DNA (16, 18, 12, other high risk), PCR, Cervical (14264); ThinPrep HPV mRNA E6/E7 (90887); SurePath HPV mRNA E6/E7 (92203); ThinPrep HPV Genotypes 16, 18/45 (91862); SurePath HPV Genotypes 16, 18/45 (92393); Chlamydia/Neisseria gonorrhoeae RNA, TMA, Urogenital (11363); Trichomonas vaginalis RNA, Qualitative, TMA, Pap Vial (90521)


Quest Diagnostics Smart Codes may not represent all of the possible screening options in published guidelines. Please contact your Quest Diagnostics representative for information on additional Pap and HPV testing options from Quest.


For all 3 Smart Codes, if a patient is over age 65: Routine cervical cancer screening may be discontinued if the patient has had adequate negative prior screening and is not otherwise at high risk.b


History of CIN 2, CIN 3, or adenocarcinoma in situ (AIS): Continue surveillance with HPV testing or co-testing at 3-year intervals for at least 25 years after treatment and initial posttreatment management, even if this extends beyond age 65.4
 

a ACOG recommendations do not specify a particular type of Pap test. Both imaged and nonimaged Pap tests are acceptable under the recommendations. Information on nonimaged Pap tests can be found at QuestDiagnostics.com/TestDirectory.
 

b Adequate negative prior screening is defined as 3 consecutive negative cytology results or 2 consecutive negative co-tests within the previous 10 years, with the most recent cytology test within 3 years or co-test within 5 years.

Cervical cancer screening and average risk for STIs (CT/NG)2,3

When cervical cancer screening is the main reason for the visit, and your patient does not have any of the symptoms or at-risk behavior for STIs, consider code 91384. Guidelines recommend annual screening for Chlamydia trachomatis and Neisseria gonorrhoeae (CT/NG) in all sexually active women younger than 25 years.3
 

Tests include
Ages (years)91384
Automated Papa with age-based screening protocols
< 21

Image-guided Pap (ThinPrep® or SurePath™)

21–24
  • Image-guided Pap (ThinPrep or SurePath)
  • CT/NG
  • HPV mRNA (if Pap is ASC-US)
25–29

Pap and HPV together as co-testing

  • Image-guided Pap (ThinPrep or SurePath)
  • HPV mRNA (if Pap is ASC-US or LSIL)
30–65
  • Image-guided Pap (ThinPrep or SurePath)
  • HPV mRNA
  • HPV genotyping 16, 18/45 (when Pap is normal and HPV is detected)
65+Image-guided Pap (ThinPrep or SurePath)
Components of panels can be ordered separately.
Cervical cancer screening and high risk for STIs (CT/NG/Trich)2,3

When your patient needs routine cervical cancer screening and has symptoms or is at risk for an STI due to a partner’s behavior, consider 91386 or 91385.
 

Tests include
Ages (years)91386
Automated Papa with age-based screening with CT/NG, Trichomonas		91385
Automated Papa with age-based screening with CT/NG
< 21

Same as 91384, plus CT/NG and Trichomonas

Same as 91384, plus CT/NG (guidelines recommend annual CT/NG screening for all sexually active women younger than 25 years5)
21–24

Same as 91384, plus Trichomonas

Same as 91384
25–29

Same as 91384, plus CT/NG and Trichomonas

Same as 91384, plus CT/NG (recommend CT/NG screening for women 25 and older when they are at increased risk3)
30–65

Same as 91384, plus CT/NG and Trichomonas

Same as 91384, plus CT/NG (recommend CT/NG screening for women 25 and older when they are at increased risk3)
65+Same as 91384, plus CT/NG and TrichomonasSame as 91384, plus CT/NG (guidelines recommend CT/NG screening for women 25 and older when they are at increased risk3)

Components of panels can be ordered separately.

 

Components for HPV mRNA Smart Codes

ThinPrep Image-guided Pap (test code 58315); SurePath™ Imaging Pap (test code 18810); HPV mRNA E6/E7 (test code 90887); HPV Genotypes 16, 18/45 (test code 91826); Trichomonas vaginalis RNA, Qualitative, TMA, Pap Vial (test code 90521); Chlamydia trachomatis RNA, TMA, Urogenital (test code 11361); Neisseria gonorrhoeae RNA, TMA, Urogenital (test code 11362); Chlamydia trachomatis/Neisseria gonorrhoeae RNA, TMA, Urogenital (test code 11363)

 

Quest Diagnostics Smart Codes may not represent all of the possible screening options in published guidelines. Please contact your Quest Diagnostics representative for information on additional Pap and HPV testing options from Quest.

 

For all 3 Smart Codes, if a patient is over age 65: Routine cervical cancer screening may be discontinued if the patient has had adequate negative prior screening and is not otherwise at high risk.b

 

History of CIN 2, CIN 3, or adenocarcinoma in situ (AIS): Continue surveillance with HPV testing or co-testing at 3-year intervals for at least 25 years after treatment and initial post-treatment management, even if this extends beyond age 65.4

 

a ACOG recommendations do not specify a particular type of Pap test. Both imaged and nonimaged Pap tests are acceptable under the recommendations. Information on nonimaged Pap tests can be found at QuestDiagnostics.com/TestDirectory.

 

b Adequate negative prior screening is defined as 3 consecutive negative cytology results or 2 consecutive negative co-tests within the previous 10 years, with the most recent cytology test within 3 years or co-test within 5 years.

We offer support materials that make it even easier to deliver the best patient care

Download
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Smart Codes simplify the ordering process so you can provide the care she needs

Quest is in-network with the majority of health plans nationwide

Quanum® Solutions that help you order tests and make data-driven decisions to help streamline your practice

Over 2,400 Patient Service Centers with simple online scheduling and shorter wait times

Interface with 1,000+ EHR systems

Rapid test results that patients can access through MyQuest®

​References:

  1. Women’s Preventive Services Initiative. Recommendations for well-woman care—a well-woman chart. 2026. Accessed September 3, 2026. 
https://www.womenspreventivehealth.org/wellwomanchart/
  2. ACOG. Screening for cervical cancer. Committee Statement No. 28. Obstet Gynecol. 2026;148(1):e63-e67. doi:10.1097/AOG.0000000000006257
  3. CDC. Screening recommendations and considerations referenced in treatment guidelines and original sources. Sexually transmitted infections treatment guidelines, 2021. Reviewed March 22, 2024. Accessed September 3, 2026. https://www.cdc.gov/std/treatment-guidelines/screening-recommendations.htm
  4. Perkins RB, Guido RS, Castle PE, et al. 2019 ASCCP risk-based management consensus guidelines for abnormal cervical cancer screening tests and cancer precursors. J Low Genit Tract Dis. 2020;24(2):102-131. doi:10.1097/LGT.0000000000000525
  5. CDC. Adolescents. Sexually transmitted infections treatment guidelines, 2021. Reviewed July 22, 2021. Accessed September 3, 2026. https://www.cdc.gov/std/treatment-guidelines/adolescents.htm

 

Test codes may vary by location. Please contact your local laboratory for more information.

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Smart Codes

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For assistance with questions about the testing process or locations, call 1.866.MYQUEST (1.866.697.8378)

Our company

Quest® is the brand name used for services offered by Quest Diagnostics Incorporated and its affiliated companies. Quest Diagnostics Incorporated and certain affiliates are CLIA-certified laboratories that provide HIPAA-covered services.  Other affiliates operated under the Quest® brand, such as Quest Consumer Inc., do not provide HIPAA-covered services. 

 

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