| Test Code | Test Name | CPT Code |
| 58315 | Pap | 88175 (HCPCS: G0145) |
| 90934 | Pap, reflex HPV, if ASCUS (ages 21 and over) | 88175 (HCPCS: G0145) |
| 90933 | Pap and HPV (cotesting for ages 30-65) | 88175 (HCPCS: G0145), 87624 |
| 91339 | Pap and HPV, CT/NG (cotesting with STI risks) | 88175 (HCPCS: G0145), 87624, 87491, 87591 |
| 91414 | Pap & HPV mRNA E6/E7, reflex HPV 16,18/45 Pap has to be neg, HPV has to be detected, then reflex to 16, 18/45 |
88175 (HCPCS: G0145), 87624 |
| Out of the Vial | ||
| 11361 | Chlamydia trachomatis RNA, TMA | 87491 |
| 11362 | Neisseria gonorrhoeae RNA, TMA | 87591 |
| 11363 | Chlamydia/N. Gonorrhoeae RNA, TMA | 87491, 87591 |
| 90521 | Trichomonas vaginalis RNA, Qualitative, TMA, PAP Vial | 87661 |
| 90569 | Herpes Simplex Virus, Type 1 and 2 DNA, Real-Time PCR, Pap Vial | 87529 (x2) |
Methodology: CYTYC Imaging System
Clinical Significance: Liquid Based Pap Testing is intended for use in the screening and detection of cervical cancer, pre-cancerous lesions, atypical cells and all other cytologic categories as defined by The Bethesda System for Reporting Results of Cervical Cytology. Pap screening is not reliable for the detection of endometrial cancer.
Additional Preferred Specimen Collection:
ThinPrep Brush/Spatula
Supply: C02 - ThinPrep Vial & Broom Kit
Preferred Specimen(s): Pap sample collected in preservcyt, alcohol-based solution that serves as preservative, transport and antibacterial medium for gynecologic samples. For invitro use only.
PAP TEST LUBRICATION JELLY MEMO
1. Obtain an adequate sampling from the cervix using a broom-like device. If desired, use lukewarm water to warm and lubricate the speculum. Water-soluble gel lubricant sparingly applied to the posterior blade of the speculum can be used if necessary.1 Insert the central bristles of the broom into the endocervical canal deep enough to allow the shorter bristles to fully contact the ectocervix. Push gently, and rotate the broom in a clockwise direction five times.
2. Rinse the broom as quickly as possible into the PreservCyt solution vial by pushing the broom into the bottom of the vial 10 times, forcing the bristles apart. As a final step, swirl the broom vigorously to further release material. Discard the collection device.
3. Tighten the cap so that the torque line on the cap passes the torque line on the vial.
4. Record the patient's name and ID number on the vial, and the patient information and medical history on the cytology requisition form.
5. Place the vial and requisition in a specimen bag for transport to the laboratory.
Transport container: Vials filled with Preservcyt
Transport temperature: Room temperature
- Unlabeled vial
- leakage of fluid during transport
- mismatch between name of patient on vial and name on test requisition
For additional supply or collection device information, please contact DLO's Customer Service at (800) 891-2917, option 2.
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 payor being billed.
1 Cervicovaginal Cytology Based on the Papanicolaou Technique; Approved Guideline – Third Edition (Clinical and Laboratory Standards Institute GP15-A3).