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High Risk Patient Criteria for PAP Test

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 studies.
  • 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, or cryosurgery.
  • 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 and younger.
  • 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 or biopsy.
  • 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 Pap test.

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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