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HCPCS G0476: HPV High-Risk Nucleic Acid Detection for Cervical Screening
HCPCS Level II code G0476 identifies laboratory testing for high-risk human papillomavirus (HPV) nucleic acid detection performed in conjunction with a Pap test for cervical cancer screening. This molecular diagnostic code is nationally important because high-risk HPV testing is integral to cervical cancer prevention strategies and impacts screening workflows, laboratory utilization, and payer coverage policies across commercial and public programs. Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise overview of the clinical context for HPV high-risk nucleic acid testing, typical sites of service, and where this test fits into guideline-directed cervical cancer screening. The publication summarizes coverage considerations and common billing practices, common modifiers associated with laboratory and professional components, and benchmarks for utilization and reimbursement where available. It also highlights policy and coding nuances relevant to laboratories, clinicians who order co-testing with Pap tests, and revenue cycle teams managing claims for molecular diagnostics.
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Billing Code Overview
HCPCS Level II code G0476 describes infectious agent detection by nucleic acid (DNA or RNA) for high-risk human papillomavirus (HPV) types used for cervical cancer screening. The service specifies detection of high-risk HPV genotypes (for example, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) and must be performed in addition to a Pap test.
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Service type: Laboratory molecular diagnostic test (HPV high-risk nucleic acid detection)
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Typical site of service: Clinical or hospital laboratory; specimen collection typically occurs in outpatient gynecology or primary care settings where cervical cancer screening is performed.