Improving Health Care Quality
Cervical cancer is one of the most detectable and treatable types of cancer, and early identification offers the best chance of a full recovery. The Pap smear is a procedure that detects any abnormal cells that might develop into cervical cancer and identifies any infection or other abnormalities and is one of the most effective cancer-screening tools. Its use has drastically reduced cervical cancer deaths among women.
What are the current cervical cancer screening guidelines?
Ensuring our female members have access to regular cervical cancer screenings is one of our highest priorities. We follow screening guidelines that recommend a Pap smear once every three years for women ages 21 to 29. It’s recommended that women ages 30 to 64 have a Pap smear every five years, combined with a test for Human Papilloma Virus (HPV), which can commonly lead to cervical pre-cancer. Women who are high risk for cervical cancer should follow their doctor’s recommendations.
HEDIS® Tip Sheet: Cervical Cancer Screening
The National Committee for Quality Assurance (NCQA) collects Healthcare Effectiveness Data and Information Set (HEDIS) measurements. Blue Cross and Blue Shield of Texas (BCBSTX) collects HEDIS data from our providers to measure and improve the quality of care our members receive. Cervical Cancer Screening (CCS) is a (HEDIS) measure, see the NCQA website for more details.
Measure Definition
The percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria:
- Women 21–64 years of age who had cervical cytology performed within the last three years.
- Women 30–64 years of age who had cervical high-risk human papillomavirus (hrHPV) testing performed within the last five years.
- Women 30–64 years of age who had cervical cytology/high-risk human papillomavirus (hrHPV) co-testing within the last five years.
Medical Record Documentation and Best Practices
- Educate our members about the importance of early detection and encourage testing
- Document hysterectomy or absence of cervix in the medical record when applicable
- Document ICD-10 exclusion codes that indicate why screening was not performed, such as hysterectomy or acquired absence of cervix
- Discuss possible fears our members may have regarding pelvic examination and cervical cytology testing
- Use reminder systems in your electronic medical records (EMR) for screenings and checkups to avoid gaps in care
Resources
Reference and review the BCBSTX Preventive Care Guidelines (PCGs), Clinical Practice Guidelines (CPGs) and THSteps for Medical Providers which includes all current vaccine schedules, ImmTrac2, and other important guidance for treating your patients.
Additional Resources
- Call the American Cancer Society toll-free at 1-800-ACS-2345 or visit the website.
- Visit the Blue Cross ahealthyme for more information about cervical cancer risk factors, symptoms, treatments, and more.
- Access the CDC page for cervical cancer screening.
1 NCQA HEDIS 2020 Technical specifications for health plans, volume 2, Washington DC, 2020
HEDIS is a registered trademark of NCQA. Use of this resource is subject to NCQA’s copyright. The NCQA HEDIS measure specification has been adjusted pursuant to NCQA’s Rules for Allowable Adjustments of HEDIS. The adjusted measure specification may be used only for quality improvement purposes.
The above material is for informational purposes only and is not a substitute for the independent medical judgment of a physician or other health care provider. Physicians and other health care providers are encouraged to use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment. The fact that a service or treatment is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider.