Cervical Cancer Screening and Diagnosis (CPB 0443, reviewed 2026-07-22)

REQUIREMENTS: - By August 21, 2026 (30 days from policy date): Billing team must review and update all cervical cancer screening and diagnostic billing workflows to reflect new self-collection device coverage options (Teal Wand for HPV testing alone or in combination with separate clinician-collected cytology for women aged 30-65). - Update prior authorization rules and encounter forms to clearly indicate that self-collected HPV testing devices are now equally acceptable alternatives to speculum-collected tests for screening when medical necessity criteria are met. - Ensure billing software correctly processes claims for extended HPV genotyping (Abbott Alinity m High-Risk HPV Assay, BD Onclarity HPV Assay) with appropriate medical necessity codes for women aged 30-65 undergoing HPV-based screening. - Flag and reject any claims submitted for experimental/non-covered procedures: artificial intelligence-based cervical cancer screening, cervicography/speculoscopy, DNA methylation triage testing, DYSIS Smart Colposcopy, and FISH testing for cervical cancer. - Educate providers that HPV testing remains non-covered (experimental) for women under age 30, for vaccine selection, and for men. - Verify that claims for women with hysterectomy do not include Pap screening charges; these are non-covered for complete hysterectomy with no cervical history. - Consequences of inaction: Claims using outdated protocols may be denied or delayed; inappropriate billing for non-covered experimental procedures will result in claim denials and possible compliance issues.