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Cervical Cytology, Female aged from 25 to 64.

Includes (In last 5 years)

4K22. Cervical smear: negative
4K23. Cerv.smear: mild dyskaryosis
4K24. Cerv.smear: severe dyskaryosis
4K25. Cerv.smear:severe dysk.?inv.ca
4K26. Cervical smear: ? gland neopl.
4K27. Cervical smear:atrophic change
4K28. Cerv.smear: mod.dyskaryosis
4K29. Cerv.smear: borderline changes
4K2C. Smear NAD - no endocervical cells present
4K2H. Cervical smear epithelial cells absent
4K2F. Cervical smear pus cells present
4K2G. Cervical smear red blood cells present
4KA1. Vaginal vault smear negative
4KA3. Vaginal vault smear-atrophic
4KA4. Vaginal vault smear abnormal
6856. Ca cervix screen - up to date
6859. Ca cervix - screen done
685B. Ca cervix screen normal
685C. Ca cervix screen abnormal
685D. Ca cervix screen + fee claim
685R Liquid based cervical cytology screening
7E2A2 Papanicolau smear NEC
7E2A3 Vaginal vault smear
ZV762 [V]Screening for malignant neoplasm of cervix
7E2A0 Exam female genital tract under anaesth & papanicolau smear
4K2Q. Cervical smear - human papillomavirus negative
4K2R. Cervical smear - human papillomavirus positive
4K2N. Cervical smear - ?endocervical type glandular neoplasia
4K2P. Cervical smear - ?non-cervical type glandular neoplasia
4K291 Cervical smear - borderline change in endocervical cells
4K290 Cervical smear - borderline change in squamous cells
4K2M. Crv smr - hi grade dyskaryosis? invasive squamous carcinoma
4K2K. Cervical smear - high grade dyskaryosis (moderate)
4K2J. Cervical smear - low grade dyskaryosis
4K2L. Cervical smear - high grade dyskaryosis (severe)
4K55. Cervical cytology test
4K3E. HPV - Human papillomavirus test negative

Exclusion codes (Every 5 years)

6853. Ca cervix screen - not wanted
685L. Cervical smear refused
8I6K Cervical smear not indicated
9O8Q Cerv. smear disclaimer received
 
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Hysterectomy codes (ever)

685H. No smear- benign hysterectomy
685I. No smear-amputation of cervix
685K. No smear - no cervix
9O8Y No cervical smear required - no uterus
7E05. Vaginal excision of uterus
7E050 Vaginal hysterocolpectomy and excision of periuterine tissue
7E051 Vaginal hysterectomy and excision of periuterine tissue NEC
7E052 Vaginal hysterocolpectomy NEC
7E053 Vaginal hysterectomy NEC
7E054 Laparoscopic vaginal hysterectomy
7E055 Vaginal hysterectomy with conservation of ovaries
7E056 Laparoscopic-assisted vaginal hysterectomy with bilateral salpingo-oophorectomy
7E058 Vaginal hysterectomy and left salpingo-oophorectomy (v30)
7E057 Vaginal hysterectomy and right salpingo-oophorectomy (v30)
7E05y Other specified vaginal excision of uterus
7E05z Vaginal excision of uterus NOS
7E040 Abdominal hysterocolpectomy and excision periuterine tissue
7E042 Abdominal hysterocolpectomy NEC
7E043 Total abdominal hysterectomy NEC
7E046 Radical hysterectomy
7E049 TAH - Tot abdom hysterectomy and BSO - bilat salpingophorect
7E04B Lapar total abdominal hysterect bilat. salpingo-oophorectomy
7E04G Total abdominal hysterectomy with conservation of ovaries
7E04P Radical hysterectomy with bilateral salpingo-oophorectomy (v30)
7E04N Radical hysterectomy with conservation of ovaries (v30)
7L0A. Clearance of pelvis, etc
7L0A0 Total exenteration of pelvis
7L0A1 Anterior exenteration of pelvis
7L0A2 Posterior exenteration of pelvis
7L0Ay Other specified clearance of pelvis
7L0Az Clearance of pelvis NOS
26L3. Uterine cervix absent

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CS indicator 002

The percentage of women aged 25 or over and who have not attained the age of 65 whose notes record that a cervical screening test has been performed in the preceding 5 years

CS 002.1 Rationale

This indicator is designed to encourage and incentivise contractors to continue to achieve high levels of uptake in cervical screening.

The contractor may be required to provide evidence of the number of eligible women, aged 25 or over and under the age of 65, who have had a cervical screening test performed in the last five years/60 months.

This indicator differs from all the other additional service indicators in that a sliding scale will apply between 45 and 80 per cent, in a similar way to the clinical indicators.

Exception reporting (as detailed in the clinical domain) will apply and specifically includes women who have had a hysterectomy involving the complete removal of the cervix.

The exception reporting rules regarding criteria A require that three separate invitations are offered to the patient before that patient can be recorded as 'did not attend'. Therefore:

In those areas where the first two invitations are sent via the central screening service, then contractors are responsible for offering the third invitation before exception reporting patients as DNA; or

Where the central screening service sends out only one letter, then contractors are responsible for offering the second and third invitations before exception reporting patients as DNA.

The exception reporting criteria is not applicable to contractors that have opted to run their own call/recall system. These contractors will still be required to offer all three invitations directly in order to meet the DNA criteria. Copies of the letters sent by the contractor may be required for assessment purposes.

Women can choose to withdraw from the national screening programme. As the indicator requires that screening is delivered every five years, in order for a woman to be exception reported for this period, criteria G which requires that a discussion has taken place between the patient and the practitioner before 'informed dissent' can be recorded.

Women who withdraw from cervical screening call/recall will receive no further offers of screening from the central screening service.

England. NHS Cancer Screening Programme. http://www.cancerscreening.nhs.uk/cervical/index.html

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CS 002.2 Reporting and verification

See indicator wording for requirement criteria.

NHS England may require that the contractor can provide a computer print-out showing the number of eligible women on the contractor list, the number exception reported and the number who have had a cervical screening test performed in the preceding five years. Contractors can exception report patients in the same way as the clinical indicators and NHS England may enquire how patients who are exception reported are identified and recorded.

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Prepared By Jean Keenan