Cytology, Pap Smear
2000624
Ordering Recommendation
 
Mnemonic
GG REQUEST
Methodology
Microscopy
Performed
Mon-Fri
Reported
1-14 days  
New York DOH Approval Status
This test is New York DOH approved.
Submit With Order
Specimen Required
Patient Preparation
1. In premenopausal patients, obtain specimens during the second half of the menstrual period to avoid contamination by obscuring blood.
2. Instruct the patient not to douche or engage in sexual intercourse within 24 hours of the procedure.  
Collect
(See below for specific instructions)
1. Label the slide(s) with the patient's first and last name, date of birth, and specimen source directly on the frosted end of the glass, in pencil, before beginning the procedure. THE LABORATORY WILL NOT ACCEPT UNLABELED SLIDES. Note that a PAP smear folder labeled with the patient's name is not adequate for patient identification. The patient information must appear on the slide.
2. Obtain all specimens prior to bimanual examination.
3. Place the patient in the lithotomy position. Using an unlubricated vaginal speculum (saline may be used as a lubricant) visualize the cervix as fully as possible.
4. After collection and proper fixation of specific specimens as outlined below, place slide(s) in a cardboard slide folder and submit to the Cytopathology Laboratory, with the clinical information.  
Specimen Preparation
Routine Cervical/Endocervical (Pap) Smear (1 slide)*
Specimens Required:
 Unstained cervical or cervical/endocervical slides.
Supplies:
 Vaginal speculum, plastic extended-tip spatula, cytobrush***, fixative** (spray fixative or bottle of 95 percent ethyl alcohol), clean glass slide (single-end frosted) and a black lead lab pencil.
Collection Procedure:
 Label one slide with the patient's first and last name, date of birth, and specimen source (prior to obtaining the specimen). Obtain specimen prior to bimanual examination. Use an unlubricated speculum (saline or warm water may be used). After visualization of the cervix is accomplished insert the cytobrush*** into the endocervical canal and rotate half a turn. Withdraw the cytobrush and spread the collected material quickly and evenly onto the half of the slide opposite the frosted end. The endocervical mucus will prevent air-drying during collection of the subsequent cervical component. Using the extended-tip spatula, scrape material with the spatula from the whole circumference of the cervix. Withdraw the spatula and spread the collected material quickly and evenly onto the half of the slide adjacent to the frosted end. Fix immediately (drop slide into fixative or spray with fixative, holding the spray bottle approximately 8 to 12 inches from the slide). Complete the Cytology test request form as indicated, including relevant clinical information. Submit the specimen to the Cytopathology Laboratory.

Routine Vaginal Smear - 1 or More Slides
Indications:
 Can be used in conjunction with routine cervical/endocervical smears in individuals with a uterus, or alone in hysterectomized patients.
Specimen Required:
 Lateral vaginal wall smear or smear of sample from a clinically concerning area.
Supplies:
Vaginal speculum, one or more plastic cervical spatulas, fixative** (spray fixative or 95% ethyl alcohol), one or more clean glass slides (single-end frosted) and a black lab pencil.
Collection Procedure:
If only a routine lateral vaginal wall sample will be obtained, label one slide with the patient's first and last name, date of birth, and specimen source. If vaginal sample will be obtained in conjunction with a cervical and endocervical component, make sure that the slides are also appropriately labeled according to site. If smears from separate vaginal areas are also to be obtained, label the sites accordingly as to specific site (e.g., left lateral vaginal wall, posterior vaginal wall, etc.). Obtain specimens prior to bimanual evaluation. Use an unlubricated speculum (saline or warm water may be used). Scrape the desired region of the vaginal mucosa with the spatula. Withdraw the spatula and spread the material quickly and evenly onto the glass slide (if cervical/endocervical smears are also obtained, or smears from other areas of the vagina are obtained, make certain that each smear is performed on the correspondingly labeled slide). Fix immediately (drop slide into fixative or spray with fixative, holding the spray bottle approximately 8 to 12 inches from the slide). Scrape additional areas of the vagina that appear abnormal and spread and fix as above. Submit the specimen to the Cytopathology Laboratory with relevant clinical history.

Routine Cervical/Endocervical (PAP) Smear (2 or More Slides)*
Specimens Required:
Unstained cervical or endocervical slides.
Supplies:
 Vaginal speculum, plastic extended-tip spatula, cytobrush***, fixative** (spray fixative or bottle of 95% ethyl alcohol), two clean glass slides (single end frosted) and a black lead lab pencil.
Collection Specimen:
 Label two slides with the patient's first and last name, date of birth, and specimen source (prior to obtaining the specimen). Obtain specimens prior to bimanual examination. Use an unlubricated speculum (saline or warm water may be used). After visualization of the cervix is accomplished, scrape material with the spatula from the whole circumference of the cervix. Withdraw the spatula and spread the collected material quickly and evenly onto the glass slide. Fix immediately (drop slide into fixative or spray with fixative, holding the spray bottle approximately 8 to 12 inches from the slide). Insert the cytobrush*** into the endocervical canal and rotate half a turn. Withdraw the cytobrush and spread the collected material quickly and evenly onto the second slide. Fix immediately (drop slide into fixative or spray with fixative, holding the spray bottle approximately 8 to 12 inches from the slide). Submit the specimen to the Cytopathology Laboratory with relevant clinical history.

Vaginal Smear, DES Exposure - 2 or more slides
Indications:
Evaluation of potential changes associated with in utero DES exposure.
Specimens Required:
 Lateral vaginal wall sample, cervical sample, endocervical sample.
Supplies:
 Vaginal speculum, one or more cervical spatulas, one extended-tip spatula, cytobrush***, fixative** (spray fixative or 95% ethyl alcohol), two or more clean glass slides (single end frosted), black lead lab pencil, and test request form as indicated.
Collection Procedure:
 Label two or more slides with patient's first and last name, date of birth, and specimen source. Label one slide "C" and one "LVW." Label others as necessary (see below). Obtain specimens prior to bimanual examination. Use an unlubricated speculum (saline or warm water may be used). After visualization of the upper 1/3 of the vagina is accomplished, with the spatula scrape the upper 1/3 of either lateral vaginal wall. Withdraw the spatula and spread the material quickly and evenly onto the slide clearly marked "LVW." Fix immediately (drop slide into fixative or spray with fixative, holding the spray bottle approximately 8 to 12 inches from the slide). Scrape additional areas of the vagina that appear abnormal. Label slides accordingly (prior to sampling) and spread and fix as above. Obtain routine cervical and endocervical specimens as outlined in the respective procedures. These smears should be collected on the slide labeled "C." Submit the specimen to the Cytopathology Laboratory with relevant clinical history.

* Procedures for collection of the cervical and endocervical components on either one or two slides are provided.
**Most hair sprays no longer contain adequate amounts of alcohol for appropriate fixation.
***Endocervical sampling devices other than a cytobrush may be used. Refer to specific specimen collection procedures provided with these devices for more information.  
Storage/Transport Temperature
Ambient  
Unacceptable Conditions
Frozen  
Remarks
  
Stability
Indefinite  
Reference Interval
   
Interpretive Data
 
Note
A conventional pap smear is used as a screening test for evaluation of the lower female genital tract to detect the presence of inflammatory/infectious or benign proliferative conditions; detection of unsuspected or confirmation of suspected atypical, premalignant, or malignant changes; or follow-up of patients with known and/or treated premalignant or malignant lesions.
CPT Code(s)
CPT codes vary based on testing performed.
Components
Component Test Code*Component Chart Name
2001220Conventional Pap Smear Source
8100100Clinical History
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.
Aliases
  • Pap smear