The American Cancer Society estimates that in 2021 there will 14,480 new cases of invasive cervical cancer diagnosed in the United States and approximately 4,290 women will die from cervical cancer. Cervical pre-cancers are diagnosed far more often than invasive cervical cancer which is another reason why screening is critical.
The HEDIS guideline for cervical cancer screening is the percentage of women 21–64 years of age who were screened according to the following criteria:
• Women 21–64 years of age who had cervical cytology performed within the last 3 years.
• Women 30–64 years of age who had cervical high-risk human papillomavirus (hrHPV) testing performed within the last 5 years.
• Women 30–64 years of age who had cervical cytology/high-risk human papillomavirus (hrHPV) cotesting within the last 5 years.
• Total, radical, complete abdominal or vaginal hysterectomy with no residual cervix, cervical agenesis or acquired absence of cervix any time during the member’s history through December 31 of the measurement year.
• Documentation of vaginal hysterectomy.
• Documentation of a vaginal pap smear in conjunction with documentation of hysterectomy.
• Documentation of hysterectomy with documentation that the member no longer needs pap testing/cervical cancer screening (Documentation of hysterectomy alone does not meet the criteria because it is not sufficient evidence that the cervix was removed.)
• Members in hospice or palliative care.
• Absence of cervix: ICD-10 codes - Q51.5, Z90.710, Z90.712
Tips for success:
• Develop a call-back system to remind patients who are due for screening exams.
• Educate patients on the importance of routine screenings.
• Request patient information from specialists for your patents who have seen an OB-GYN.
• Document exclusions correctly to meet criteria. You must say “total” or “complete” or “radical” hysterectomy or “no residual cervix”.
• Biopsy-only reports do not count for cervical cancer screening.
• Ensure the chart includes documentation of the test performed with both the date and results.