The CCS-E measure allows at-home, self-collected HPV vaginal samples that are sent to a laboratory or provider's office for analysis (see General Guideline: Self-Collected Samples). Organizations can identify qualifying screenings through multiple approved data sources, including claims, laboratory data, electronic clinical data and medical records. The absence of a specific code does not exclude identification of a qualifying screening if the organization can demonstrate numerator compliance using an approved data source that meets the requirements of the measure.
When using supplemental data (e.g., laboratory data, electronic clinical data or medical record documentation) to assess the numerator (i.e., the provider did not bill one of the codes in the measure), the documentation must meet the requirements outlined in General Guideline: Supplemental Data. NCQA does not approve code mapping, and the auditor will determine whether the data meet the intent of the measure.
If a laboratory bills for the test using any of the CPT codes in the High Risk HPV Lab Test Value Set then this meets numerator criteria. The CPT codes are not specific to sample type (vaginal versus cervical) therefore billing is based on the specific assay and types being detected by the laboratory.
**This FAQ applies to HEDIS Volume 2 MY 2026 & MY 2027.
This applies to the following Programs and Years:
HEDIS MY 2027
