Article ID Number: A58216 Status: A-Approved
Article Title: Billing and Coding: Screening for Cervical Cancer with Human Papillomavirus (HPV)
Original Article Effective Date:
Revision Effective Date:
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.
Notice: It is not appropriate to bill Medicare for services that are not covered as if they are covered. When billing for non-covered services, use the appropriate modifier.
Consistent with National Coverage Determination (NCD) 210.2.1 screening HPV services are to be billed with Healthcare Common Procedure Coding System (HCPCS) code G0476. These services require dual diagnosis codes. The primary International Statistical Classification of Diseases and Related Health Problems, 10th revision, (ICD-10) code Z11.51 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].
Please refer to NCD 210.2.1 for complete information on screening for cervical cancer with Human Papillomavirus (HPV).