Pap Smear

CERNER / EPIC MNEMONIC: PAP SMEAR
CPT CODE: 88164
DAYS PERFORMED: Mon-Fri, 0730-1700
TURNAROUND TIME: 3-7 days
SPECIAL INSTRUCTIONS: Slides must be labeled with the patient`s last name. Last menstrual period (LMP), previous Pap smear date, and previous Pap smear diagnosis are required information. Pertinent clinical information including exogenous hormone therapy, chemotherapy, radiation, prior gynecologic surgery, and pregnancy should also be indicated.
CONTAINER TYPE: Pap smear collection kit
COLLECTION: VCE (vaginal, cervical, endocervical Pap smear):

Scrape the midlateral wall of the vagina very lightly with a spatula and keep the sample on the spatula.

Scrape lightly the entire ectocervix with another spatula and keep this sample on the spatula.

Introduce cytobrush device into the endocervix and rotate. Smear the endocervical specimen on the section of the slide farthest from the frosted end, and in quick succession spread the cervical sample in the middle section of the slide and the vaginal specimen on the section closest to the frosted end.

Fix the smear immediately after spreading all three sections by spraying with fixative held 8-12 inches from slide.

SPECIMEN REQUIREMENTS: Vaginal, cervical, endocervical scraping
REJECTION CRITERIA: No patient name on slide, discrepancy between specimen labeling and requisition.
ADDITIONAL INFORMATION: The Bethesda System is used for reporting cervical Pap smear specimens. The reporting system includes a statement of Adequacy in one of the following categories; Satisfactory, Satisfactory but limited by, Unsatisfactory or Unacceptable. Each Satisfactory or Satisfactory but limited by sample is classified by one of the following general categories: Negative for Intraepithelial malignancy, Epithelial abnormality or Malignancy other. Each general category is then characterized by a standardized set of descriptors.

Unsatisfactory specimens are identified as to the reason for being unsatisfactory. Examples include Scant specimens or specimens obscurred by blood or inflammation.

Unacceptable specimens are characterized by the reason for being unacceptable and are returned to the submitting office. Examples include no patient name on slide or a discrepant patient name on slide from the requisition submitted.