HPV Test Covered Only With Abnormal PapSmear

The human papillomavirus virus (HPV) test (CPT procedure codes 87620-87622) is covered by TRICARE only when performed after an abnormal Pap smear, i.e., for the assessment of women with atypical squamous cells of undetermined significance (ASCUS) or low-grade squamous itraepithelial (LSIL) cells.

The HPV test is not covered when performed as a screening test simultaneously with a regular Pap smear, e.g., if you indicate on your claim that the HPV test was included in the screening as "standard practice," the claim will be denied. Remember to send the test to a network laboratory.

For further information, refer to the TRICARE Policy Manual, Chapter 6, Section 1.1 at www.tricare.mil, www.triwest.com or call 1-888-TRIWEST (888-874-9378).