Tech & Innovation in Healthcare

Key reminder for ob-gyn coders: You won’t be billing the lab codes.

Patients coming into your ob-gyn practice are likely already asking about at-home cervical cancer screening — or soon will be.

With growing awareness of the at-home cervical cancer screening kits and paired virtual visits, practices, payers, and labs are fielding questions not just about access and coverage, but about how these services are billed. As the medical coder for an ob-gyn practice, you’re on the front line of translating this new care model into clean, accurate claims.

Understanding which components your practice reports (and which belong to a lab or a third-party telehealth provider) is essential to avoid denials, delays, or compliance issues.

What Are At-Home Cervical Cancer Screening Kits?

At-home screening kits are not new, as colorectal cancer stool sample screening kits, diabetes screening, and fertility testing kits have been on the market for years. However, at-home cervical cancer screenings are new entrants to healthcare, and one company is combining collection and telehealth.

In 2025, the U.S. Food and Drug Administration (FDA) authorized the Teal Wand, marking the first FDA-authorized at-home cervical cancer screening option available nationally. This innovation allows individuals ages 25 to 65 at average risk to collect their own vaginal sample for cervical cancer screening in the privacy of their home — without a speculum exam — and mail it to a certified laboratory for high-risk human papillomavirus (HPV) testing, the same testing methodology used in traditional clinical settings.

The kit is paired with a brief telehealth visit for eligibility assessment, prescription, and results review.

Important: If your ob-gyn writes the prescription for a Teal Wand screening kit, that does not automatically mean your practice is billing for all telehealth services associated with the Teal Wand program. In many workflows, eligibility screening, ordering, or results counseling may be provided by Teal Health-affiliated clinicians, not your ob-gyn practice itself.

Understand the Product and Service Workflow

The at-home kit is designed to collect a self-sample that will be tested for high-risk HPV, the virus responsible for nearly all cervical cancers.

After FDA authorization, Teal Health rolled out the Teal Wand nationwide, and included virtual access to licensed medical providers who:

• Prescribe the kit
• Guide patients through the process
• Review results and coordinate follow-up

Laboratory analysis is performed by a certified laboratory using FDA-approved assays (for example, Roche cobas^® HPV or similar high-risk HPV nucleic acid tests).

The care pathway generally includes:

1. A virtual visit to determine eligibility and prescribe the at-home screening kit;
2. The patient performing self-collection at home and mailing the specimen to a certified lab;
3. Laboratory testing for high-risk HPV and results reporting; and
4. A follow-up virtual visit for abnormal results, counseling, and referrals.

Learn How to Code the Laboratory Component

From a coding standpoint, the HPV nucleic acid detection test is billed by the performing laboratory, not the ob-gyn practice.

Relevant CPT^® codes for high-risk HPV testing include:

• 87624 (Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68), pooled result)
• 87625 (Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), types 16 and 18 only, includes type 45, if performed)
• 87626 (Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), separately reported high-risk types (eg, 16, 18, 31, 45, 51, 52) and high-risk pooled result(s))

CPT^® code 87626, effective in 2025, replaces a former Category III code and reflects expanded genotype reporting when it’s supported by the lab’s testing platform.

Ob-gyn coder takeaway: Even though your provider orders the test, do not bill 87624, 87625, or 87626 unless your practice owns and performs the laboratory service. These CPT^® codes belong on the lab’s claim.

Note: Under Medicare, HCPCS Level II code G0476 (Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be performed in addition to pap test) may still appear in some payer policies, but historically the code required co-testing with cytology and it may not apply to standalone HPV screening. Always verify current payer guidance.

Select the Correct Diagnosis Codes for the Screening

When applicable to your practice’s claim, ICD-10-CM screening diagnoses may include:

• Z12.4 (Encounter for screening for malignant neoplasm of cervix)
• Z11.51 (Encounter for screening for human papillomavirus (HPV))

Diagnosis codes should align with the professional service provided, not the lab test.

Code the Telehealth Visits

When your ob-gyn practice provides telehealth services (such as counseling, ordering the test, or reviewing results) these encounters are reported using evaluation and management (E/M) telehealth codes, not lab codes.

Common options include:

• New patient outpatient E/M: 99202-99205 (Office or other outpatient visit for the evaluation and management of a new patient …)
• Established patient outpatient E/M: 99212-99215 (Office or other outpatient visit for the evaluation and management of an established patient …)

Your claim should clearly document the telehealth encounters: who provided the service, patient location, and real-time interactive method. Only bill for services your clinicians actually perform; do not bill for external telehealth providers.

Heads up: There are no separate “telehealth-only” E/M CPT^® codes for these services. You use the same office visit codes you would use for in-person care and indicate telehealth via modifiers and place of service (POS).

Other important things to note include:

• Code selection should be based on medical decision making (MDM) and supported documentation.
• Append the appropriate telehealth modifier (for example, 95 [Synchronous telemedicine service rendered via real-time interactive audio and video telecommunications system], GT [Via interactive audio and video telecommunication systems], or payer-specific modifier) and use the correct POS (for example, POS 02 [Telehealth Provided Other than in Patient’s Home]), per payer policy. Medicare generally prefers POS 02 for telehealth provided when the patient is not in their home, while some commercial payers allow POS 10 (Telehealth Provided in Patient’s Home) when the patient is home. Always verify payer-specific rules for telehealth POS.
• If the telehealth visit is performed by a Teal Health provider and not your ob-gyn practice, you should not submit an E/M claim for that service.

Recognize What the Ob-Gyn Practice Does Not Bill

To prevent denials and duplicate billing:

• HPV laboratory CPT^® codes (for example, 87624, 87626)
• Specimen collection codes (patient self-collects at home)
• Device or kit supply codes (unless explicitly contracted and payer-allowed)
• Telehealth visits not performed by your clinicians

Follow These Documentation Tips

Strong documentation is critical. The physician needs to document crucial information, such as:

• Clearly identifying who performed the telehealth visit
• Documenting the purpose of the encounter (screening counseling, ordering, results review)
• Linking the correct screening diagnosis code
• Confirming telehealth modifiers and POS accuracy
• Avoiding billing services rendered by external entities

Takeaway

The Teal Wand at-home cervical cancer screening kit, paired with virtual care, represents a meaningful shift in how preventive gynecologic services are delivered. Success hinges on proper claim separation:

• The laboratory bills the HPV test (for example, 87624 or 87626).
• Your ob-gyn practice bills only for its own professional telehealth E/M services, when performed.

Always verify your payer’s latest policies before billing. Coding guidance may be accurate, but coverage rules and modifiers can differ.

Staying current on payer policies, telehealth billing rules, and evolving HPV screening guidance will help ensure compliant, reimbursable claims as this new screening model becomes more common.

Suzanne Burmeister, BA, MPhil, Medical Writer and Editor