Cervical Cancer Screening Guidelines for HMO Members

This guide outlines the cervical cancer screening criteria for members aged 21 to 64 years under the Premera Blue Cross HMO plan. It details the screening methods, which include cervical cytology and high-risk human papillomavirus (hrHPV) testing, specifying the time frames for these screenings. Members are excluded from screening if they have certain medical conditions, such as a hysterectomy or if they are male. The document also provides specific coding for exclusions and screenings, including CPT, HCPCS, and LOINC codes, which are essential for accurate medical record documentation and billing. Additionally, it includes tips for successful patient care, emphasizing the importance of opportunistic screening, updating patient contact lists, and educating both patients and care teams about the benefits of early detection. The guide stresses the need for proper documentation and electronic data submission to health plans, as well as the regular review of tip sheets to incorporate technical specification updates from the National Committee for Quality Assurance.