Laboratory Test Directory

Is of child bearing age and has had an examination within the last three years indicating the presence of cervical or vaginal cancer or other abnormalities.

Has a history of:
    Onset of sexual activity before 16 years of age
    Multiple sexual partners
    Sexually transmitted disease
    Fewer than 3 negative Pap smears within the last 7 years
    DES (diethylstilbestrol) –exposed daughters of women who took DES
    during pregnancy

Medicare will reimburse one screening Pap smear every year for the high risk patients.

• ICD-9 codes for diagnostic Pap smear – These ICD-9 codes are used for patients exhibiting signs or symptoms of vaginal or cervical disease. The ICD-9 code used for diagnostic Pap smears must represent the symptom or sign of cervical disease of the patient. Medicare will reimburse all these Pap smears as they are considered a medical necessity.

The most common ICD-9 codes used for diagnostic Pap smears are:

622.1 for dysplasia of cervix excludes CIS and CIN III
627.1 for postmenopausal bleeding
627.4 for induced menopausal bleeding
626.9 for abnormal uterine bleeding
616.10 for vaginitis, unspecified
182.0 for endometrial carcinoma
180.1 for malignant neoplasm of cervix (squamous cell carcinoma)
183.0 for ovarian carcinoma
054.10 for genital herpes
623.5 for vaginal discharge
626.4 for Irregular menstrual cycle
626.8 for dysfunctional uterine bleeding (DUB)
626.2 for menometrorrhagia or menorrhagia
616.50 for vulva ulcer
795.0 for non specific abnormal Pap of cervix