See Specimen Submission Instructions for test requisition, specimen labeling and specimen packaging requirements.

Patient Instructions

1. The Pap test should ideally be taken two weeks after the first day of the last menstrual period. The patient should avoid scheduling her appointment during heavy menstrual bleeding; excessive amounts of blood may compromise the quality of the specimen and may lead to an unsatisfactory result.
2. The patient should avoid the use of vaginal medications, vaginal contraceptives, douches, lubricants, and sexual intercourse at least 48 hours prior to examination.

Use of Lubricant

1. NCCLS guidelines recommend that no lubricant be used during the pap test. ¹ ACOG recommends that care be taken not to contaminate the specimen with lubricant ². Use of lubricant may lead to an unsatisfactory result and insufficient specimen remaining for ancillary testing.

¹ Papanicolaou Technique Approved Guidelines (NCCLS Document GP 15-A)

² ACOG Practice Bulletin, no. 45, August, 2003

Pertinent Clinical Information

It is essential to provide all pertinent clinical information.  Please include:

1. Specimen source, e. cervicovaginal, vaginal
2. ICD code
3. Date of last menstrual period or menstrual status; pregnant, post-partum, postmenopausal, or has had a hysterectomy.
4. Clinical history to include contraceptive/hormone treatment, abnormal bleeding, +HPV, lesion, high risk factors, surgical/treatment history including biopsy, LEEP, radiation etc.

Endocervical Brush / Spatula Protocol:

1. Specimen Collection

• With a pencil, label slide with patient’s first and last name and one additional unique patient identifier.
• Ectocervix Sample

Insert contoured end of spatula into the cervical os and while maintaining tight contact with the ectocervical surface rotate one full turn (360 degrees).  Smear thinly on ½ of the slide and immediately spray fix.

• Endocervix Sample

Insert cytobrush into the cervix until only the bottom-most fibers are exposed.  Slowly rotate ¼ turn to ½ turn in one direction.  Do not over-rotate. Using moderate pressure, roll brush on remaining ½ of the slide (make certain to complete 360 degree turn) and immediately spray fix.

• Spray fixative: hold fixative 3 inches from the slide and spray 1-3 times. Failure to fix immediately could cause Pap smear to be unsatisfactory for evaluation.
• Allow spray fixative to dry then place slide into cardboard or plastic slide holder.

Broom-Like Device Protocol:

1. Specimen Collection
2. • With a pencil, label slide with the patient’s first and last name and 1 additional unique patient identifier.

• Ectocervix and Endocervix Sample

Insert the central bristles of the broom into the endocervical canal deep enough to allow the shorter bristles to fully contact the ectocervix.  Push gently, and rotate the broom in a clockwise direction five times.

Smear each side of the broom onto a glass slide and immediately spray fix.

• Spray fixative: hold fixative 3 inches from the slide and spray 1-3 times. Failure to fix immediately could cause Pap smear to be unsatisfactory for evaluation.
• Allow spray fixative to dry then place slide into cardboard or plastic slide holder.

CPT code    

88164
88141 (Pathologist Review)