Listed below are clinical features utilized
by PLA to determine high-risk status. This list includes, but
is not limited to, all high-risk features as defined by the Centers
for Medicare & Medicaid Services (CMS).
History of any of the following ALWAYS
qualifies the specimen as high risk, regardless of the time since
any pertinent procedure or diagnosis:
- High-grade squamous intraepithelial lesion
(HSIL), carcinoma in situ (CIS), or cervical, endometrial, ovarian
or vulvar malignancy of any type, diagnosed by Pap test or tissue
- Chemotherapy, radiotherapy, and/or surgical
treatment for cervical, endometrial, ovarian, or vulvar malignancy
of any type.
- Cervical biopsy (including LEEP, cone,
endocervical curettage), abnormal endometrial biopsy, colposcopy,
- Unspecified abnormal or atypical Pap test,
including inflammatory atypia, with no other information provided
(e.g. how long since occurrence, etc.).
- Friable cervix.
- Pregnancy in-patients younger than 18
years of age.
- All tests on patients 16 years of age
- Abnormal bleeding at any age.
- Any bleeding in a postmenopausal female.
- D & C in a postmenopausal female.
- Previous or current sexually transmitted
disease, including genital herpes, HPV, and HIV infection.
- Question of previous abnormal Pap test
- DES exposure.
- History of early onset of sexual activity
(e.g. before 16 years of age).
- Multiple sexual partners (five or more
in a lifetime).
- Fewer than three negative Pap tests within
the previous seven years.
History of any of the following within
five years prior to the current PAP test qualifies the specimen
as high risk:
- Low-grade squamous intraepithelial lesion
(LSIL) or atypical squamous or glandular cells.
- Any previous unspecified abnormal or atypical
History of any of the following does NOT
qualify the Pap test as high risk:
- Unspecified previous abnormal or atypical
Pap test greater than five years prior to the current Pap test.
- AS/GUS or LSIL greater than five years
prior to the current Pap test.
- Carcinoma not primary to the female genital
tract, unless metastatic to the female genital tract.
- D & C in a premenopausal female.
For Non-gynecologic specimens, document
the clinical information on the test request form under the Clinical
History/Special Request header and write any pertinent clinical
information related to the specimen collected.
Name of the referring physician: Clearly
write the name of the referring physician and how that individual
may be contacted if additional information is required or results
need to be reported by phone.
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