Currentblue cross blue shield - tennesseePolicy N/A

Cervical Cancer Screening

Defines coverage criteria and limitations for cervical cancer screening (Pap smear, high-risk HPV testing, and co-testing) across age groups and immunosuppression status, aligned with major guideline recommendations; includes FDA-approved assays and references to Medicare/Medicaid applicability.

Policy Summary

Payerblue cross blue shield - tennessee

PolicyCervical Cancer Screening

Policy CodePolicy N/A

Change TypeAdoption (effective 7/1/2023)

Effective DateJul 1, 2023

Next Review DateN/A

Key ActionDocument age, immunosuppression status, prior cervical dysplasia/cancer, and prior screening results (number and dates) to determine coverage applicability.

SourceLink

POLICY UPDATE CHANGES

No material changes — policy adoption recorded but no material clinical or coverage changes.

Age-basedCoverage Structure

IncludedHigh-risk exceptions

MultipleAssays cited

7/1/2023Effective adoption

Coverage Summary

Defines coverage criteria and limitations for Cervical Cancer Screening (Papanicolaou/Pap smear, high-risk HPV testing, and co-testing) across age groups and immunosuppression status, aligned with major guideline recommendations from the USPSTF, ACOG, NCCN, ACS, ASCCP and others.

The policy uses an age-based structure with specific intervals and techniques by age cohort (e.g., every 3 years for Pap-based screening in 21–29 and options including Pap every 3 years, hrHPV alone every 5 years, or co-testing every 5 years for 30–65), includes high-risk exceptions for immunosuppressed individuals, cites FDA-approved HPV assays and LDT considerations, and is effective 2023-07-01.