January is Cervical Cancer Awareness Month

Despite advances in prevention, cervical cancer remains way too prevalent. In 2020, 11,542 cervical cancer cases were diagnosed in the United States, and 4,272 women died from this disease, according to the latest statistics from the Centers for Disease Control and Prevention.

Cervical Cancer Awareness Month, which occurs during January, is an excellent opportunity to further educate patients about what can be done to fight this devastating disease.

The American College of Obstetricians and Gynecologists recommends using well visits to counsel patients on maintaining a healthy lifestyle while minimizing health risk. Vaccination administration and appropriate screenings can help female patients lower their risk of cervical cancer.

Vaccinations

The human papilloma virus (HPV) has been identified as a major cause of cervical cancer. The HPV vaccination can help protect women from multiple types of HPV infection.

The HPV vaccination is routinely recommended for preteens ages 11–12 (can start at age 9). Expanded guidelines for the HPV vaccine now include high-risk adults who are 27–45 years of age.

Screenings

Pap and HPV tests can help identify early signs of cervical cancer and prevent the disease from developing further, making it easier to treat.

HEDIS® Measures

The Healthcare Effectiveness Data and Information Set (HEDIS®) is a widely used set of healthcare performance measures for a variety of clinical procedures, including cervical cancer screenings. HEDIS measures promote excellent patient care, especially in the critical area of disease prevention.

The Cervical Cancer Screening (CCS) measure evaluates females, 21–64 years of age, who were screened for cervical cancer using any of the following criteria:

  • 21–64 years who had cervical cytology performed within the last three years
  • 30–64 years who had cervical cytology/high-risk human papillomavirus (hrHPV) co-testing within the last five years
  • 30–64 years who had cervical high-risk human papillomavirus (hrHPV) testing performed within the last five years.

HEDIS Exclusions for the CCS Measure

  • Members with a history of a hysterectomy with no residual cervix, cervical agenesis, or acquired absence of cervix.
  • Members currently in hospice and/or have received hospice services during the measurement year.
  • Members currently receiving palliative care any time during the measurement year.
  • Members who died any time during the measurement year.

Tips

  • Exclusions – Look back as far as possible in the member’s history for exclusions.
  • Closing Gaps – Be proactive by evaluating practice processes for opportunities to close care gaps every time a patient is seen.
    • Always document the date and result of the most recent exam.
  • Hysterectomies – Documenting that a member had a hysterectomy does not exclude the member unless the cervix is totally removed.
    • If a member had their cervix removed, please indicate with the appropriate ICD-10 codes.
  • Biopsies – Do not count biopsies as they are diagnostic and therapeutic only. These are not valid for primary cervical cancer screening.
  • Labs – Lab results that indicate the sample contained “No Endocervical Cells” may be acceptable if a valid result is reported for the test.
  • Documentation – The medical record must include the following:
    • A note indicating the date the procedure was performed.
    • The result or finding.

Annual gynecological exams can be a life-saving appointment — remind your patients about their importance!

Acknowledgement

This article is based in part on information from HEDIS MY 2024 Volume 2: Technical Specifications.

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).

Highmark does not recommend particular treatments or health care services. This information is not intended to be a substitute for professional medical advice, diagnosis, or treatment. You should determine the appropriate treatment and follow-up with your patient. Coverage of services is subject to the terms of each member’s benefit plan. Additionally, state laws and regulations governing health insurance, health plans and coverage may apply and will vary from state to state.


 

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