Medicare has changed the guidelines for payment of screening and diagnostic pap smears and pelvic exams by allowing for payment once every two years instead of once every three. This new rule applies to services provided on or after July 1, 2001.
Here is some information about the difference between screening and diagnostic testing. Screening Pap Smears are routine lab tests used for the early detection of cancer. If you are low risk, (no cancer history, no abnormalities in past tests) Medicare will consider payment for this test once every two years. If you are high risk (high cancer risk or past abnormal tests) Medicare will consider payment every year. You can talk to your doctor about whether or not you are at risk, and he/she will bill Medicare accordingly. Screening Pelvic Exams have the same guidelines as screening pap smears.
Diagnostic Pap Smears are tests that are performed if you have or have had cancer, if you have had an abnormal pap smear in the past, or if you have any other signs or symptoms of a gynecological disorder. There are no particular limits to the number of diagnostic pap smears that a woman can have, but payment is based upon the diagnosis that is submitted with the test.
Your health is important, and these valuable tests can help you to stay well. Always talk to your doctor about any health questions you may have.
last updated on 10/03/2011