Cervical Cancer Awareness and Screening

Published 01/28/2025

Who Is at Risk for Cervical Cancer?

All women are at risk for cervical cancer, but it occurs most often in women over age 30. Talk with your patients about cervical and vaginal cancer screenings. 

Almost all cervical cancers are caused by human papillomavirus (HPV), a common virus that can be passed from one person to another during sex. There are many types of HPV. Some HPV types can cause changes on your cervix that can lead to cervical cancer over time, while other types can cause genital or skin warts.

HPV is so common that most people get it at some time in their lives. HPV usually causes no symptoms and, for most people, HPV will go away on its own. If it doesn't, it can cause cervical cancer over time.

Other Things That Can Increase Risk of Cervical Cancer

  • HIV infection or other diseases weakening the immune system
  • Medication that suppress immune response, such as organ rejection prevention, autoimmune diseases or cancer treatment
  • Reproductive factors such as oral contraceptives and giving birth to many children
  • Obesity
  • Tobacco smoking

High Risk Factors for Cervical and Vaginal Cancer

  • Early onset of sexual activity (under 16 years of age)
  • Multiple sexual partners (five or more in a lifetime)
  • History of sexually transmitted disease (including HIV infection)
  • Fewer than three negative or any pap smears within the previous seven years; and
  • DES (diethylstilbestrol) — exposed daughters of women who took DES during pregnancy

Note: Claims for pap smears must indicate the beneficiary’s low or high risk status by including the appropriate diagnosis code on the line item (Item 24E of the Form CMS-1500).

What are Cervical Cancer Symptoms?

Early on, cervical cancer, usually doesn’t have symptoms, making it hard to detect. Symptoms usually begin after the cancer has spread.

Symptoms of Early-Stage Cervical Cancer May Include

  • Vaginal bleeding after sex
  • Vaginal bleeding after menopause
  • Vaginal bleeding between periods or periods that are heavier or longer than normal
  • Vaginal discharge that is watery and has a strong odor or that contains blood
  • Pelvic pain or pain during sex

Symptoms of Advanced Cervical Cancer

Symptoms of advanced cervical cancer (which is cancer has spread beyond the cervix to other parts of the body) may include the symptoms of early-stage cervical cancer and the following:

  • Difficult or painful bowel movements or bleeding from the rectum when having a bowel movement
  • Difficult or painful urination or blood in the urine
  • Dull backache
  • Swelling of the legs
  • Pain in the abdomen
  • Feeling tired

Help your patients reduce their risk of cervical cancer. The most import things to help prevent cervical cancer are to vaccinate against HPV, regular screenings, and follow up care if screening test results are abnormal. 

Human Papillomavirus (HPV) Vaccine

The HPV vaccine protects against the types of HPV that most often cause cervical, vaginal, and vulvar cancers.

  • HPV vaccination is recommended for preteens aged 11 to 12 years but can be given starting at age nine
  • HPV vaccine also is recommended for everyone through age 26 years if they are not vaccinated already
  • HPV vaccination is not recommended for everyone older than age 26 years. However, some adults aged 27 through 45 years who are not already vaccinated may decide to get the HPV vaccine after speaking with their doctor about their risk for new HPV infections and the possible benefits of vaccination. HPV vaccination in this age range provides less benefit, as more people have already been exposed to HPV.

If vaccination is started before age 15, a two-dose schedule is recommended, with the doses given six to 12 months apart. For people who start the series after their 15th birthday, the vaccine is given in a series of three shots.

HPV vaccination prevents new HPV infections but does not treat existing infections or diseases. This is why the HPV vaccine works best when given before any exposure to HPV. Patients should get screened for cervical cancer regularly, even if they have received an HPV vaccine.

Screening Tests

A screening pap smear and related medically necessary services provided to a woman for the early detection of cervical cancer (including collection of the sample of cells and a physician’s interpretation of the test results) and pelvic examination (including clinical breast examination) are covered under Medicare Part B when ordered by a physician (or authorized practitioner) under one of the following conditions:

  • She has not had such a test during the preceding two years or is a woman of childbearing age (§1861(nn) of the Social Security Act 
  • There is evidence (based on her medical history or other findings) that she is at high risk of developing cervical cancer and her physician (or authorized practitioner) recommends that she have the test performed more frequently than every two years.

Patients in need may be able to get free or low-cost screening tests through CDC’s National Breast and Cervical Cancer Early Detection Program. Find out if you qualify.

More Steps to Help Prevent Cervical Cancer

Things That May Also Help Lower the Risk for Cervical Cancer

*HPV infection can occur in both male and female genital areas that are covered or protected by a latex condom, as well as in areas that are not covered. While the effect of condoms in preventing HPV infection is unknown, condom use has been associated with a lower rate of cervical cancer.

Screening tests and the HPV vaccine can help prevent cervical cancer. When cervical cancer is found early, it is highly treatable and associated with long survival and good quality of life.

HCPCS and CPT® Codes

  • G0123 — Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision
     
  • G0124 — Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, requiring interpretation by physician
     
  • G0141 — Screening cytopathology smears, cervical or vaginal, performed by automated system, with manual rescreening, requiring interpretation by physician
     
  • G0143 — Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under physician supervision
     
  • G0144 — Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervision
     
  • 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
     
  • G0147 — Screening cytopathology smears, cervical or vaginal, performed by automated system under physician supervision
     
  • G0148 — Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening
     
  • P3000 — Screening papanicolaou smear, cervical or vaginal, up to three smears, by technician under physician supervision
     
  • P3001 — Screening papanicolaou smear, cervical or vaginal, up to three smears, requiring interpretation by physician
     
  • Q0091 — Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory

ICD-10 Codes

  • High risk: Z72.51, Z72.52, Z72.53, Z77.29, Z77.9, Z91.89, Z92.850, Z92.858, Z92.86, Z92.89
     
  • Low risk: Z01.411, Z01.419, Z12.4, Z12.72, Z12.79, Z12.89

Note: Additional ICD-10 codes may apply. Find individual change requests and specific ICD-10-CM service codes we cover on the CMS ICD-10 webpage. Go to the Palmetto GBA website for more information.

  • G0101 — Cervical or vaginal cancer screening; pelvic and clinical breast examination

ICD-10 Codes

  • High risk: Z72.51, Z72.52, Z72.53, Z77.29, Z77.9, Z91.89, Z92.850, Z92.858, Z92.86, Z92.89
     
  • Low risk: Z01.411, Z01.419, Z12.4, Z12.72, Z12.79, Z12.89

Note: Additional ICD-10 codes may apply. Find individual change requests and specific ICD-10-CM service codes we cover on the CMS ICD-10 webpage. Go to Palmetto GBA for more information.

Medicare covers female patients with Medicare Part B.

Frequency

  • Annually (or 11 months past the month of the last covered exam) for women at high risk for developing cervical or vaginal cancer or childbearing age with abnormal Pap test within past three years
  • Every two years (or 23 months past the month of the last covered exam) for low-risk women

See FAQ on how to check eligibility.

Patient pays no copayment, coinsurance, or deductible. There have been no changes since the last quarter.

Medicare Benefits Pay for These Screenings, Tests and Exams

Your patients pay nothing if their provider accepts assignment. Find out when your patient is eligible for these screenings (PDF). If you need help, contact your eligibility service provider.

Upon providing services related to prevention, screening, and treatment for cervical cancer, be certain to review the National Coverage Determination (NCD): Screening Pap Smears and Pelvic Examinations for Early Detection of Cervical or Vaginal Cancer. This NCD also provides information regarding clinical breast examination.

References and Resources


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