Most Commonly Used ICD-9-CM Codes
Pap Screening, Reference Testing and Medical Necessity
Screening Pap Test Codes
V15.89
V22.0
V22.1
V22.2
V24.1
V24.2
V28.8
V28.9
V67.01
V72.31
V72.32
V76.2
V76.49
Other specified personal history presenting hazards to health
Supervision of normal first pregnancy
Supervision of other normal pregnancy
Pregnant state, incidental
Lactating mother
Routine postpartum follow-up
Other specified antenatal screening
Unspecified antenatal screening
Follow-up vaginal pap smear
Routine gynecological exam
Encounter for pap smear to confirm findings of recent normal smear following
abnormal smear
Special screening for malignant neoplasm of cervix
Special screening for malignant neoplasm’s other sites
Screening Pap for Low Risk Medicare Patients
*The Medicare program pays for screening services (pelvic exams & pap smears with the
appropriate HCPCS code) every two years for the early detection of cervical cancer.
An ABN is required.
V76.2
V76.47
V76.49
V72.31
Special screening for malignant neoplasm, cervix
Special screening for malignant neoplasm, vagina
Special screening for malignant neoplasm, other sites
Routine gynecological examination with or without a cervical pap smear
Screening Pap for High Risk Medicare Patients
*For beneficiaries at high risk for cervical cancer and vaginal cancer, the Medicare program will pay for
screening pap smears and pelvic exams annually.
V15.89
Other specified personal history presenting hazards to health
Diagnostic Pap Test Codes
079.4
180.9
182.0
183.0
184.0
184.4
233.1
616.0
616.10
622.1
622.10
622.11
622.12
623.0
623.5
624.8
626.2
626.4
627.1
795.00
795.01
795.02
795.03
795.04
795.05
795.08
795.09
Human Papillomavirus
Malignant neoplasm, cervix uteri unspecified
Malignant neoplasm, corpus uteri
Malignant neoplasm, ovary
Malignant neoplasm, vagina
Malignant neoplasm, vulva unspecified
Carcinoma in Situ, cervix uteri
Cervicitis
Vaginitis and vulvovaginitis, unspecified
Dysplasia of cervix
Dysplasia of cervix, unspecified
Mild dysplasia of cervix
Moderate dysplasia of cervix
Dysplasia of vagina
Leukorrhea, not specified as infective
Noninflammatory disorders of vulva and perineum
Excessive or frequent menstruation
Irregular menstruation
Postmenopausal bleeding
Abnormal glandular Papanicolaou smear of cervix
Papanicolaou smear of cervix with ASC-US
Papanicolaou smear of cervix with ASC-US cannot exclude HGSIL (ASC-H)
Papanicolaou smear of cervix with LGSIL
Papanicolaou smear of cervix with HGSIL
Cervical high risk human papillomavirus (HPV) DNA test positive
Unsatisfactory smear
Other abnormal Papanicolaou smear of cervix and cervical HPV
Reference Test Screening Codes
V73.89
V73.99
V74.5
V77.6
Other specified viral diseases
Unspecified viral disease
Special screening exam for venereal disease
Special screening for cystic fibrosis
Diagnostic Medical Necessity Codes for Medicare Patients:
179
180.0 - 180.9
182.0 - 182.8
183.0 - 183.9
184.0 - 184.9
218.0 - 218.9
219.0
219.1
233.1 - 233.3
616.10
616.11
616.8
616.9
621.0
621.30
621.31
621.32
621.33
621.8
621.9
622.0
622.10
622.11
622.12
622.2
622.7
622.8
623.0
623.1
623.5
623.6
623.7
623.8
626.2
626.8
627.0
627.1
627.3
795.00
795.01
795.02
795.03
795.04
795.05
795.08
795.09
V10.40
V10.41
V10.42
V10.43
V10.44
Malignant neoplasm of uterus, part unspecified
Malignant neoplasm of cervix uteri
Malignant neoplasm of body of uterus
Malignant neoplasm of ovary and other uterine adnexa
Malignant neoplasm of other and unspecified female genital organs
Uterine leiomyoma
Other benign neoplasm of cervix uteri
Other benign neoplasm of corpus uteri
Carcinoma in situ of genitourinary system
Vaginitis and vulvovaginitis, unspecified
Vaginitis and vulvovaginitis in diseases classified elsewhere
Other specified inflammatory diseases of cervix, vagina, and vulva
Unspecified inflammatory disease of cervix, vagina, and vulva
Polyp of corpus uteri
Endometrial hyperplasia, unspecified
Simple endometrial hyperplasia without atypia
Complex endometrial hyperplasia without atypia
Endometrial hyperplasia with atypia
Other specified disorders of uterus, not elsewhere classified
Unspecified disorder of uterus
Erosion and ectropion of cervix
Dysplasia of cervix, unspecified
Mild dysplasia of cervix
Moderate dysplasia of cervix
Leukoplakia of cervix (uteri)
Mucous polyp of cervix
Other specified noninflammatory disorders of cervix
Dysplasia of vagina
Leukoplakia of vagina
Leukorrhea, not specified as infective
Vaginal hematoma
Polyp of vagina
Other specified noninflammatory disorders of vagina
Excessive or frequent menstruation
Other dysfunctional or functional uterine hemorrhage NOS
Premenopausal menorrhagia
Postmenopausal bleeding
Postmenopausal atrophic vaginitis
Abnormal glandular Papanicolaou smear of cervix
Papanicolaou smear of cervix with ASC-US
Papanicolaou smear of cervix with ASC-US, cannot exclude HGSIL (ASC-H)
Papanicolaou smear of cervix with LGSIL
Papanicolaou smear of cervix with HGSIL
Cervical high risk human papillomavirus HPV DNA test positive
Unsatisfactory smear
Other abnormal Papanicolaou smear of cervix and cervical HPV
Personal history of malignant neoplasm, female genital organ, unspecified
Personal history of malignant neoplasm, cervix uteri
Personal history of malignant neoplasm, other part of uterus
Personal history of malignant neoplasm, ovary
Personal history of malignant neoplasm, other female genital organ