icd code for high risk hpv test cpt

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-CM code for HIV test?

The claim must document the need for the test (ICD-10-CM codes R87.619, R87.610-R87.611). If the test result is positive [e.g.: R87.810 (Cervical high risk human papillomavirus (hpv) dna test positive) or R87.811 (Vaginal high risk human papillomavirus (hpv) dna test positive)], an ICD-10-CM code denoting the test result should also be submitted.

How often should high risk HPV testing be performed?

high risk HPV testing alone may be performed every 5 years, or high risk HPV testing may be performed every 5 years in combination with Pap smear (co-testing) for routine screening. The use of HPV tests as a primary screening test for cervical cancer in women younger than 30 years of age is considered experimental and investigational.

Which HPV tests are available for cervical cancer?

Please provide SERVICE AREA INFORMATION to find available tests you can order. HPV is the causative agent of cervical dysplasia and cervical carcinoma. This assay only detects high-risk HPV types, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59 and 68.

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 CPT code for HPV testing?

51 must be reported along with one of the following secondary ICD-10-CM diagnosis codes: Z01. 411 or Z01. 419. It is incorrect to report these screening services with Current Procedural Terminology (CPT®) code 87624 [Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), high-risk types].

What is CPT code G0476?

Group 1 CPT Codes: G0476. INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HUMAN PAPILLOMAVIRUS (HPV), HIGH-RISK TYPES (E.G., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) FOR CERVICAL CANCER SCREENING, MUST BE PERFORMED IN ADDITION TO PAP TEST.

What does CPT code 87624 mean?

Infectious agent detection by nucleic acid87624. Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), high-risk. types (e.g.,16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68)

What is CPT code Q0091 used for?

A search in your electronic health record will often find HCPCS code Q0091, “Screening Papanicolaou smear; obtaining, preparing, and conveyance of cervical or vaginal smear to laboratory.” Here's when to use (and when not to use) that code.

What is CPT G0145?

G0145. Screening cytopathology, cervical or vaginal (any reporting system), collected in. preservative fluid, automated thin layer preparation, with screening by automated. system and manual rescreening under physician supervision.

What does CPT code 87591 mean?

87591 Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhea, amplified probe technique.

What does CPT code 87491 mean?

Testing for Chlamydia (CPT Code 87491) Routine screening for chlamydia infection should be performed annually in all sexually active female patients who are 25 years of age or younger (and is recommended more often for patients who have high risk factors).

What is the CPT code for 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 CPT code 87081 mean?

CPT® 87081 in section: Culture, presumptive, pathogenic organisms, screening only.

What does CPT code 87077 mean?

87077. Culture, bacterial; aerobic isolate, additional. methods required for definitive identification, each isolate. Definitive.

What does CPT code 87210 mean?

Smear, primary source with interpretationCPT® 87210 in section: Smear, primary source with interpretation.

Test Resources

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Reject Criteria

Received frozen • Cervical swabs in Digene® HC cervical sampler • Unprocessed Cytyc® media without cervical brush/broom • Swabs • Digene® vials • SurePath™ pellet • Samples treated with acetic acid • Vaginal sources • Biopsy

General Information

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

CMS National Coverage Policy

Title XVIII of the Social Security Act, Section 1833 (e) states that no payment shall be made to any provider of services or other person under this part unless there has been furnished such information as may be necessary in order to determine the amounts due such provider or other person under this part for the period with respect to which the amounts are being paid or for any prior period..

Article Guidance

It has come to our attention that services submitted for screening for cervical cancer with Human Papillomavirus (HPV) Testing have been reported incorrectly. This Billing and Coding Article provides billing and coding guidance for these services.

ICD-10-CM Codes that Support Medical Necessity

It is the provider’s responsibility to select codes carried out to the highest level of specificity and selected from the ICD-10-CM code book appropriate to the year in which the service is rendered for the claim (s) submitted.

ICD-10-CM Codes that DO NOT Support Medical Necessity

All those not listed under the “ICD-10 Codes that Support Medical Necessity” section of this article.

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.

Document Information

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

CMS National Coverage Policy

Language quoted from Centers for Medicare and Medicaid Services (CMS). National Coverage Determinations (NCDs) and coverage provisions in interpretive manuals is italicized throughout the policy.

Coverage Guidance

Abstract: Human papillomavirus (HPV) is a virus that infects epithelial cells and can induce a variety of benign and malignant tumors in humans. Most of these infections resolve spontaneously but some progress to a high-grade preinvasive cervical lesion (cervical intraepithelial neoplasia) or cervical cancer.

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+).

Does Medicare cover Pap?

Medicare Part B covers screening Pap tests and pelvic exams (including clinical breast exam) for all female patients when ordered and performed by 1 of these medical professionals, as authorized under state law:

Is CPT copyrighted?

CPT codes, descriptions and other data only are copyright 2020 American Medical Association. All Rights Reserved. Applicable FARS/HHSAR apply. CPT is a registered trademark of the American Medical Association. Applicable FARS/HHSAR Restrictions Apply to Government Use. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.