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2025 HCPCS code Q0091

Screening Papanicolaou (Pap) smear; obtaining, preparing, and conveyance of cervical or vaginal smear to laboratory.

This code is for screening Pap smears only. Do not use this code if the Pap smear is being performed for diagnostic purposes (e.g., due to symptoms or abnormal findings). For Medicare patients, this code may be billed with G0101 (pelvic and breast exam) if both are performed.

Modifiers may be applicable in certain situations. Check with individual payers.

Medically necessary for routine cervical cancer screening in women according to established guidelines (e.g., every 3 years for women aged 21-29, every 5 years for women aged 30-65).

The clinician inserts a speculum, collects cells from the cervix and/or vagina, prepares the sample, and sends it to the lab for analysis.

In simple words: This code covers the doctor taking a sample for a Pap smear, getting it ready, and sending it to the lab. It's used for women who don't have any symptoms or history of problems "down there".

This code covers the collection, preparation, and transportation of a cervical or vaginal smear to a laboratory for a screening Pap smear. It is used for patients without signs, symptoms, or a history of genital malignancy.

Example 1: A 25-year-old woman with no symptoms or history of gynecological problems comes in for a routine Pap smear., A 45-year-old woman with a history of HPV comes in for her annual Pap smear., A 60-year-old woman who has not had a Pap smear in several years comes in for a screening.

Documentation should include the reason for the Pap smear (screening) and the date of the last Pap smear, if applicable. Patient consent for the procedure should also be documented.

** Some payers may have specific frequency limitations for this code. Check individual payer policies for coverage rules. Do not use this code for Pap smears performed as part of a preventive medicine service (e.g., 99381-99397) for Medicare patients.

** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.

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