The University of Iowa (UIHC)
Department of Pathology
LABORATORY SERVICES HANDBOOK


Pap Test-Liquid Based Collection

Order Form: H-2 Cytopathology or IPR Req
  Cytopathology
5222 RCP
356-2517 PROCEDURAL QUESTIONS
Specimen
Cervical/Endocervical/Vaginal Cells in Fluid Collection Media
Minimum:
One collection vial with detached Cervex-brush(broom)head in 
proprietary fixative solution. Collection kits (SUREPATH) are available 
from Processed Stores #MHO8592.

See collection video link listed below. This video is 9 min 45 seconds 
and will take you through the step by step collection procedure.
Analytic Time:
5 working days
Reference Range:
Normal Result is: Negative for intraepithelial lesion or malignancy.
Comments:
The requisition with complete patient history must accompany the 
specimen:  Provide age, last menstrual period, type of hormones being 
received, IUD, abnormal bleeding, previous abnormal smears, 
chemotherapy and/or radiation.

Be sure and indicate if this is a Screening (preventative in nature) or 
Diagnostic (signs or symptoms of disease or high risk) Pap test. Be 
sure and label the collection container with the patient's name and 
medical record number. The sample container should contain the detached 
head of the broom (see sample collection instruction video).


Sample Collection Instructions Video
Methodology:
Cervical/Endocervical/Vaginal cells collected in a preservative fluid, 
automated liquid based preparation (AutoCyte PREP); manual screening 
under physician supervision.
CPT Code:
Screening Liquid Based Pap test HCPCS codes:
     G0123 (technical)
     G0124 (physician code if abnormal)

Diagnostic Liquid Based Pap test CPT codes:
     88142 (technical)
     88141 (physician code if abnormal)
 
See also:
Pap Smear, Cervical/Vaginal Smear
 
See Additional Information:
Pap Test Coding and Billing

Alphabetic main page

Updated: 03/26/2008

Note: The information contained in this handbook is for use by personnel of University of Iowa Health Care. No other use is implied or intended.