BILLING NEWS

Every Woman Counts Cervical Cancer Screening Update

Effective for dates of service on or after August 20, 2018, the Every Woman Counts (EWC) program includes primary human papillomavirus (HPV) testing as a screening strategy for women 30 to 65 years of age. The program recommends using the American Society for Colposcopy and Cervical Pathology (ASCCP) and the Society of Gynecologic Oncology (SGO) guidelines for follow up after primary HPV testing, including coverage for HPV genotyping, billed with CPT code 87625 (infectious agent detection by nucleic acid [DNA and RNA]; Human Papillomavirus [HPV], types 16 and 18 only, includes type 45, if performed). An Erroneous Payment Correction (EPC) will be implemented to reprocess affected claims.

U.S. Preventive Services Task Force (USPSTF) posted updated recommendations on screening average-risk women for cervical cancer. The USPSTF recommends that clinicians screen for cervical cancer in women 21 to 29 years of age every three years with the Pap test alone. For women 30 to 65 years of age, the USPSTF recommends screening either with the Pap test alone every three years, screening with the high-risk HPV test alone (primary HPV testing) every five years or screening with both tests together (co-testing) every five years. Women should talk to their clinician to choose which strategy is right for them. The USPSTF continues to recommend against screening in women younger than 21 years of age and in women older than 65 years of age who have had adequate prior screening. For more information, providers may refer to the Final Recommendation Statement page of the USPSTF website.


INDUSTRY NEWS TAGS: Payor


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