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BLUECONNECT
Providers
January 2024
In This Issue
► January news: Executive summary
► 2024 Medicare Advantage networks and plans
► "Incident-to" billing: What you need to know
► Updated pricing guidelines for E/M services provided in emergency departments
► Cervical cancer screening: Provider guidance for 2024
Cervical cancer screening: Provider guidance for 2024
HEDIS measures address a broad range of important health issues including measures that promote disease prevention and cancer screening. Cervical cancer screening (CCS) is an important step in the early detection and prevention of cervical cancer.1 Each year about 13,000 new cases of cervical cancer are diagnosed and about 4,000 women die of cervical cancer. Hispanic women have the highest risk of developing cervical cancer. Black women have the highest mortality rates associated with cervical cancer. As a healthcare provider, you can help patients understand the importance of cervical cancer screening and the screening options available to them.
Measure by measure:
Guidelines for cervical cancer screening
The Cervical Cancer Screening Measure is looking for the percentage of women 21-64 years of age who receive appropriate screening for cervical cancer. 
Appropriate screenings
• Cervical cytology performed within the last 3 years for women 21-64 years of age 
• Cervical high-risk human papillomavirus (hrHPV) performed within the last 5 years for women 30-64 years 
• Cervical cytology hrHPV co-testing within the last 5 years for women 30-64 years of age
What’s changed: Required exclusion criteria was updated for the 2024 measurement year
• Hysterectomy with no residual cervix, cervical agenesis, or acquired absence of cervix any time during the member’s history through December 31 of the measurement year
• Members in hospice or using hospice services any time during the measurement year
• Members who died any time during the measurement year
• Members receiving palliative care any time during the measurement year
Important note for Primary Care Providers: Medical record review
Cervical cancer screenings have up to a five-year lookback period for hrHPV. To capture screenings during medical record review, the documentation in the medical record must include a note indicating the date the cervical cancer screening was performed and the result.

Members with a history of hysterectomy are excluded from the cervical cancer screening measure. Documentation of “hysterectomy” alone does not meet exclusion criteria. To capture evidence of hysterectomy with no residual cervix in the medical record, the following documentation is needed: 
• Documentation of “complete,” “total,” or “radical” hysterectomy 
• Documentation of “vaginal hysterectomy”
Documentation that is no longer accepted
• Documentation of a “vaginal Pap smear” in conjunction with documentation of “hysterectomy”
• Documentation of hysterectomy in combination with documentation that the patient no longer needs Pap testing/cervical cancer screening
In This Issue
► January news: Executive summary
► 2024 Medicare Advantage networks and plans
► “Incident-to” billing: What you need to know
► Updated pricing guidelines for E/M services provided in emergency departments
► Cervical cancer screening: Provider guidance for 2024
1Source: Cervical Cancer Statistics | CDC

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