icd 10 code for pap, thinprep reflex hpv high risk if ascus

by Prof. Moriah Kassulke IV 3 min read

Full Answer

What is the ICD 10 code for high risk HPV?

Cervical high risk human papillomavirus (HPV) DNA test positive 1 R87.810 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 2 Short description: Cervical high risk HPV DNA test positive 3 The 2021 edition of ICD-10-CM R87.810 became effective on October 1, 2020. More items...

What is the ICD 10 code for papillomavirus?

2018/2019 ICD-10-CM Diagnosis Code R87.810. Cervical high risk human papillomavirus (HPV) DNA test positive. 2016 2017 2018 2019 Billable/Specific Code Female Dx.

What is the CPT code for ThinPrep Pap smear?

ThinPrep® Pap HPV DNA, High Risk with Reflex to Genotypes 16,18 Pap results requiring physician interpretation will be performed at an additional charge (CPT code(s): 88141; HCPCS: G0124). If the Pap is Normal and HPV DNA, High Risk is Detected, HPV Genotypes 16,18 will be performed at an additional charge (CPT code(s) 87625).

Which ICD 10 code should not be used for reimbursement purposes?

R87.81 should not be used for reimbursement purposes as there are multiple codes below it that contain a greater level of detail. Short description: High risk HPV DNA test positive from female genital organs The 2020 edition of ICD-10-CM R87.81 became effective on October 1, 2019.

What is the ICD-10 code for ASC-US with positive HPV?

810 for Cervical high risk human papillomavirus (HPV) DNA test positive is a medical classification as listed by WHO under the range - Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified .

What is reflex HPV for ASC-US?

What is the purpose of reflex HPV testing? The purpose of reflex HPV testing is to detect the Human Papillomavirus (HPV) in a Pap test sample and to help decide what follow up is needed for women in specific age groups with a low grade Pap test result (ASC-US or LSIL).

What is the ICD-10 code for HPV screening?

Screening for malignant neoplasm of vagina (Z12. 72) Screening for HPV (V11. 51)

What is the ICD-10 code for history of abnormal Pap smear?

Unspecified abnormal cytological findings in specimens from cervix uteri. R87. 619 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.

What is ThinPrep with reflex HPV?

ThinPrep® Imaging Pap reflex HPV DNA - 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.

What is ASC-US Pap smear result?

ASCUS ~ Atypical squamous cells of undetermined significance This diagnosis means that some of the cells on your Pap smear did not look entirely normal but did not meet diagnostic criteria for a lesion. Your doctor may either repeat your Pap smear, or perform a colposcopy.

What does diagnosis Z12 4 mean?

ICD-10 code: Z12. 4 Special screening examination for neoplasm of cervix.

How do you code HPV vaccine?

CPT code 90650 is an FDA-approved HPV vaccine for females only age 9-26. For recipients age 9-18, code 90650 is reimbursed through the VFC program. The three-dose schedule for either code for recipients over age 18 must begin and end before the recipient turns 27.

What does code Z12 31 mean?

For example, Z12. 31 (Encounter for screening mammogram for malignant neoplasm of breast) is the correct code to use when you are ordering a routine mammogram for a patient. However, coders are coming across many routine mammogram orders that use Z12. 39 (Encounter for other screening for malignant neoplasm of breast).

What is the ICD-10 code for ASC-US?

R87.610610 for Atypical squamous cells of undetermined significance on cytologic smear of cervix (ASC-US) is a medical classification as listed by WHO under the range - Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified .

Is ASC-US cervical dysplasia?

The most common categories of abnormal cell changes on the cervix (cervical dysplasia) are listed below. ASCUS (Atypical squamous cells of undetermined significance). This means your Pap smear results are borderline, between normal and abnormal.

What is the ICD code for Pap smear?

2022 ICD-10-CM Diagnosis Code Z01. 41: Encounter for routine gynecological examination.

What is a high risk HPV test?

A positive high-risk HPV test result indicates that the patient may be infected with one or more of the following HPV genotypes: 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59 and 68, which are associated with cervical cancer and its precursor lesions; however, cross-reactions with other genotypes may occur.

What is a Pap smear?

A Pap smear examines the cells of the cervix and detect s cell abnormalities. Both, cancerous and precancerous cells can be detected. Pap tests are recommended in women ages 21 - 64, every two years with normal Pap results. Vaginal Pap smears can also be performed but must be noted on the requisition.

Is B97.7. R87.810 cervical?

HPV testing must be positive by viral detection tests in order to code as B97.7. R87.810 is not appropriate as there is no reference to this being cervical & it could very well be anal, but in either case neither are correct to use. That is unless it is documented, as coding based on assumption is not allowed.

Is B97.7 a positive HPV?

For the HPV+ as long as it is officially documented by a physician as HPV+ you could could use B97.7. This is not to be confused with p16 positivity. HPV-positive is not equivalent to HPV mediated (p16+). HPV-type 16 refers to virus type and is different from p16 overexpression (p16+).

General Information

CPT codes, descriptions and other data only are copyright 2020 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.

Article Guidance

This article gives guidance for billing, coding, and other guidelines in relation to local coverage policy for L34089-Human Papillomavirus (HPV) Testing.

ICD-10-CM Codes that Support Medical Necessity

It is the responsibility of the provider to code to the highest level specified in the ICD-10-CM. The correct use of an ICD-10-CM code listed below does not assure coverage of a service. The service must be reasonable and necessary in the specific case and must meet the criteria specified in this determination.

Bill Type Codes

Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type.

Revenue Codes

Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination.