Name of the Procedure:

Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision (HCPCS G0145).

Summary

This procedure involves collecting cervical or vaginal cells in a preservative fluid. These cells are then prepared on a thin layer slide using automated technology. Initial screening is conducted by an automated system, followed by a manual rescreening under physician supervision to detect any abnormalities.

Purpose

• Medical Conditions Addressed: Screening for precancerous changes, cervical cancer, and other abnormalities in cervical or vaginal cells.
• Goals/Outcomes: Early detection and management of cervical cancer, thereby improving treatment outcomes and reducing mortality rates.

Indications

• Symptoms/Conditions: Unusual discharge, bleeding, or pelvic pain.
• Patient Criteria: Women aged 21-65, sexually active women, especially those with a history of HPV or abnormal Pap smears.

Preparation

• Pre-procedure Instructions:
  • Avoid douching, sexual intercourse, or using vaginal medications 48 hours before the test.
  • Schedule the test when not menstruating.

Procedure Description

1. Collection: A healthcare provider collects cervical or vaginal cells using a brush or spatula.
2. Preservation: The cells are placed in a liquid preservative.
3. Preparation: In the lab, the sample is prepared on a thin layer slide using automated technology.
4. Screening: An automated system initially screens for abnormalities.
5. Rescreening: A manual rescreening is performed by a cytopathologist under physician supervision to confirm findings.

Duration

The cell collection process typically takes 5-10 minutes. Laboratory analysis may take several days.

Setting

Performed in outpatient settings such as clinics, healthcare centers, or physician's offices.

Personnel

• Physicians
• Cytotechnologists
• Medical laboratory technicians

Risks and Complications

• Common Risks: Mild discomfort or spotting after sample collection.
• Rare Risks: Infection.

Benefits

• Early Detection: Identifies precancerous changes before they develop into cancer.
• Improved Outcomes: Early intervention can lead to better treatment success.

Recovery

• Post-procedure Care: Minimal. Patients can resume normal activities immediately.
• Recovery Time: Immediate.
• Follow-up: Depends on results, may include routine screenings or further diagnostic tests.

Alternatives

• Other Options: Conventional Pap smear, HPV DNA testing, visual inspection with acetic acid (VIA).
• Pros and Cons:
  • Conventional Pap smear is less automated and may have higher variability.
  • HPV DNA testing is more specific but doesn't provide cytological analysis.
  • VIA is low-cost but less precise.

Patient Experience

• During the Procedure: Typically mild discomfort similar to a pelvic exam.
• After the Procedure: Some spotting or mild cramping may occur. Pain management is usually unnecessary, but over-the-counter pain relievers can be used if needed.

This structured approach ensures comprehensive patient understanding and preparedness for the G0145 screening procedure.