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US · guidance

CMS Pub. 100-04, ch. 18, § 30.8

MSN Messages

activein force · 2026-08-25 – presentas-observed

If there are no high risk factors, and the screening Pap smear and/or screening pelvic examination

is being denied because the procedure/examination is performed more frequently than allowed use

MSN 18.17:

Medicare pays for a screening Pap smear and/or screening pelvic examination only once

every (2, 3) years unless high risk factors are present.

HPV Screening: Effective for claims with dates of service on and after July 9, 2015:

A. If denying line-items on claims containing HCPCS G0476, HPV screening, when reported

more than once in a 5-year period [at least 4 years and 11 full months (59 months total) must elapse

from the date of the last screening], use the following messages:

(Part A Only) MSN 15.19: “Local Coverage Determinations (LCDs) help Medicare decide what is

covered. An LCD was used for your claim. You can compare your case to the LCD, and send

information from your doctor if you think it could change our decision. Call 1-800-MEDICARE

(1-800-633-4227) for a copy of the LCD”.

Spanish Version - Las Determinaciones Locales de Cobertura (LCDs en inglés) le ayudan a decidir

a Medicare lo que está cubierto. Un LCD se usó para su reclamación. Usted puede comparar su

caso con la determinación y enviar información de su médico si piensa que puede cambiar nuestra

decisión. Para obtener una copia del LCD, llame al 1-800-MEDICARE (1-800-633-4227).

MSN 15.20: “The following policies NCD 210.2.1 were used when we made this decision.”

Spanish Version – “Las siguientes políticas NCD 210.2.1 fueron utilizadas cuando se tomó esta

decisión.”

B. If denying line-items on claims containing HCPCS G0476, HPV screening, when the

beneficiary is not between the ages of 30-65, use the following messages:

(Part A Only) MSN 15.19: “Local Coverage Determinations (LCDs) help Medicare decide what is

covered. An LCD was used for your claim. You can compare your case to the LCD, and send

information from your doctor if you think it could change our decision. Call 1-800-MEDICARE

(1-800-633-4227) for a copy of the LCD”.

Spanish Version - Las Determinaciones Locales de Cobertura (LCDs en inglés) le ayudan a decidir

a Medicare lo que está cubierto. Un LCD se usó para su reclamación. Usted puede comparar su

caso con la determinación y enviar información de su médico si piensa que puede cambiar nuestra

decisión. Para obtener una copia del LCD, llame al 1-800-MEDICARE (1-800-633-4227).

MSN 15.20: “The following policies NCD 210.2.1 were used when we made this decision."

Spanish Version – “Las siguientes políticas NCD 210.2.1 fueron utilizadas cuando se tomó esta

decisión.”

C. If denying line-items on claims containing HCPCS G0476, HPV screening, when the claim

does not contain the appropriate ICD-10 diagnosis codes listed below:

ICD-10: Z11.51 and Z01.411 or, Z01.419

Use the following messages:

(Part A Only)MSN 15.19: “Local Coverage Determinations (LCDs) help Medicare decide what is

covered. An LCD was used for your claim. You can compare your case to the LCD, and send

information from your doctor if you think it could change our decision. Call 1-800-MEDICARE

(1-800-633-4227) for a copy of the LCD”.

Spanish Version - Las Determinaciones Locales de Cobertura (LCDs en inglés) le ayudan a decidir

a Medicare lo que está cubierto. Un LCD se usó para su reclamación. Usted puede comparar su

caso con la determinación y enviar información de su médico si piensa que puede cambiar nuestra

decisión. Para obtener una copia del LCD, llame al 1-800-MEDICARE (1-800-633-4227).

MSN 15.20: “The following policies NCD 210.2.1 were used when we made this decision.”

Spanish Version – “Las siguientes políticas NCD 210.2.1 fueron utilizadas cuando se tomó esta

decisión.”

History

(Rev. 11021; Issued: 10-01-21; Effective: 10-29-21; Implementation: 10-29-21)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
1e359168d537fd4a0c005141482e3bd2bde0c5a8fab2a1c7bda2dfbafa870314
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