Cervical Cancer Screening Reimbursement Information
Defines Blue Cross Blue Shield Oklahoma lab management reimbursement criteria for cervical cancer screening (Pap cytology, high-risk HPV testing, and co-testing), including frequencies, age- and risk-based exceptions, non-reimbursable situations, and an associated procedure code list. Applies to individuals with a cervix; plan documents may further limit applicability.
Added new CPT code 87626 effective 01/01/2025.
Updated reimbursement criteria to add 'immunocompromised' to criterion #1 and revised frequencies and age applicability across multiple items.
Document language changed from 'women' to 'individuals' throughout reimbursement information.
Removed prior policy criteria allowing screening in individuals under 21 only when certain conditions were met; current policy states screening <21 is not reimbursable except as specifically addressed.
Clarified definition of 'adequate screening history' for stopping screening at >65.