HEDIS® Tip Sheet

Cervical Cancer Screening (CCS)

Line of business: BlueAlliance (Commercial) & BlueAlliance Care+ (Medicaid)

Measure Description

Percentage of Members 21-64 years of age who had a screening for cervical cancer using either of the following criteria:

  • Members 21-64 who had cervical cytology performed within the last 3 years.
  • Members 30-64 who had testing for cervical cancer screening using either of the following criteria:
    • Cervical high-risk human papillomavirus (hrHPV) testing performed within the last 5 years.
    • Cervical cytology/hrHPV co-testing within the last 5 years.

Compliance

  • Members 24-64 years of age as of December 31 of the measurement year who had cervical cytology during the measurement year or the 2 years prior to the measurement year.
  • Members 30-64 years of age as of December 31 of the measurement year who had cervical high-risk papillomavirus (hrHPV) testing during the measurement year or the four years prior to the measurement year and who were 30 years or older on the date of the test.
    • Evidence of hrHPV testing within the last 5 years also captures patients who had co-testing.
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Medical Records should include:

  • For women between the age of 24 and 64 years who had cervical cytology:
    • A note indicating the date when the cervical cytology was performed.
    • The results or findings.
  • For women between the age of 30 and 64 years who had cervical high risk human papillomavirus (hrHPV) testing during the measurement year of the four years prior to the measurement year and who were 30 years or older as of the date of testing:
    • A note indicating the date when the hrHPV test was performed.
    • The results or findings.

Medical Record Documentation that is not acceptable:

  • Lab results indicating that the sample was inadequate or that “no cervical cells were present”.
  • Biopsies are not to be included as they are diagnostic and therapeutic, therefore are not for primary cervical cancer screening.
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Exclusions

  • History of hysterectomy with no residual cervix.
  • Cervical agenesis or acquired absence of cervix. 
  • Members with sex assigned at birth of male.
  • Members in hospice during the measurement year.
  • Members who received palliative care during the measurement year.
  • Members who died during the measurement year.
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Best Practices

  • Engage in state programs such as ScreeND.
  • Prepare charts prior to appointments each day, verifying last screening.
  • Establish a standing order for eligible population.
  • Utilize EMR to set gap in care alerts.
  • Educate providers/patients of appropriate screening guidelines and importance of early detection.

Cervical Cytology Lab Test Codes



Coding Disclaimer

The analysis of any medical coding question related to a measure is dependent on the measure’s technical specifications including the factual situations present related to the member, the practice, the professionals, and the medical services provided.

Questions  

Should you have specific coding or other questions related to the measure, please send your questions to BlueAlliance@bcbsnd.com.

 

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