Screening Pap Smears and Pelvic Examinations for Early Detection of Cervical or Vaginal Cancer

Medicare Part B covers screening Pap smears and medically necessary pelvic examinations (including clinical breast exams) when ordered by a physician or authorized practitioner, generally at a two-year interval for eligible women. Coverage also applies to women of childbearing age and to women at high risk (specific risk factors listed) who may be tested more frequently; claims must document risk status (diagnosis code on CMS-1500 Item 24E) and pelvic exams should document at least seven of eleven specified elements.

"Medicare Part B covers a screening Pap smear and related medically necessary services when ordered by a physician or authorized practitioner for a female beneficiary who has not had a Pap smear dur..."

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