Starting March 3, 2025, Ontario Health is implementing a significant change in cervical cancer screening by transitioning from PAP tests to primary HPV (Human Papillomavirus) testing. This update aims to improve early detection, reduce unnecessary testing, and streamline screening intervals. To support these changes, OSCAR Pro has introduced new features and eForms, ensuring a seamless transition for physicians using the EMR system.
Why is HPV Screening Replacing PAP Smears?
Cervical cancer is primarily caused by high-risk HPV infections. While PAP tests detect abnormal cervical cells after they have changed, HPV testing identifies the virus before these changes occur. Research has shown that HPV testing is more effective at detecting pre-cancerous changes and allows for longer screening intervals, reducing unnecessary follow-ups.
Key Changes for Physicians
Updated Ontario Cervical Screening Program (OCSP) Guidelines
- Screening will begin at age 25 instead of 21.
- Patients who test negative for HPV will now have screening intervals of five year instead of three.
- HPV testing will also be incorporated into colposcopy for determining post-discharge screening intervals.
New Requisition Forms & Specimen Collection Requirements
Physicians must use the updated HPV and Cytology Test Requisition – for Cervical Screening form when ordering tests for eligible patients. Additionally, specimen collection will require the ThinPrep® system, as samples collected using SurePath™ will be rejected. To avoid processing issues, providers should familiarize themselves with the How to Collect a Cervical Sample guide.
Designated Laboratory Service Providers
The following labs will process all program-related HPV and cytology tests:
- LifeLabs
- Dynacare
- North Bay Regional Health Centre
Other community labs will provide supply delivery and courier services. Physicians should contact these labs directly for processing and logistical support.
OSCAR Pro Updates to Support HPV Screening
To assist with this transition, OSCAR Pro has implemented several updates:
New HPV Prevention Entry
A prevention item, “HPV Test” will be available under the Screenings category in OSCAR Pro, aligning with Ontario Health’s screening guidelines.
New HPV Screening eForms for Seamless Documentation
As of March 3, 2025, the following eForms are available on all OSCAR Pro systems:
- ON HPV-Cytology for Cervical Screening
- ON HPV-Cytology for Colposcopy Follow-up
These eForms are designed to pre-populate patient and provider data from the EMR, reducing manual entry and minimizing errors. Additionally, a built-in instruction form provides guidance at the point of data entry, ensuring clinicians follow proper procedures while preventing unnecessary printouts.
How to Access the eForms in OSCAR Pro
- Navigate to the eChart of the patient.
- Click the + beside eForms.
- Select the required HPV eForm from the list.
Tips for Faster eForm Access in OSCAR Pro
Finding and using eForms efficiently can save time. Here are some key tips:
- Use Web Text Search: On Windows, press CTRL+F; on macOS, press CMD+F to quickly location eForms.
- Group eForms: Organize frequently used eForms into custom categories to improve accessibility.
- Set Favourite eForms: Users can designate a Favourite eForm Group in Preference for instant access.
- Enable Hover Over eForm Access: If enabled, hovering over the + in eChart will instantly display a list of Favourite eForms.
For more information on the HPV screening updates in OSCAR Pro, read our article on our Knowledge Base here.
OHIP Billing Code Updates
With the transition to HPV testing, Ontario has introduced new tracking codes under the OCSP, effective March 3, 2025:
- L734 – Cervicovaginal cellular evaluation/PAP (for tracking only)
- L699 – Human Papillomavirus (HPV) testing (for tracking only)
Additionally, as of April 3, 2025, existing laboratory codes L713 and L733 will no longer be used for the OCSP.
Updated Fee Codes
| Code | Description | Value |
| G365 | Collection of cervical cancer screening specimen | $12.00 |
| E430 | Cervical cancer screen specimen collected outside hospital | $11.95 |
| G394 | Additional cervical cancer screening specimen | $12.00 |
| E431 | Follow-up cervical cancer screen specimen collected outside hospital | $11.95 |
Minimum age eligibility for G365 and E430 has been increased from 21 to 25 years old. Additionally, G365 and G394 cannot be billed alongside certain colposcopy-related procedure codes (Z730, Z731, Z787). If billed together, one service will be paid at $0.
HPV Screening Coverage for Non-OHIP Patients
Cervical screening and colposcopy-related tests for individuals without OHIP coverage are not included in the Ontario Cervical Screening Program (OCSP). Patients with Interim Federal Health (IFH) Program coverage are also excluded from OCSP but have similar test and treatment coverage as residents of their province.
Currently, HPV testing for IFH-covered individuals can be ordered at no cost through LifeLabs, Dynacare, and North Bay Regional Health Centre. Physicians should use standard cytology test processes and the appropriate requisition forms.
Next Steps for Physicians
To ensure a smooth transition, physicians should:
- Update patient screening schedules according to the new guidelines.
- Use the updated requisition forms for HPV and cytology tests.
- Follow proper specimen collection methods using ThinPrep®.
- Stay informed on billing changes and OHIP fee code updates.
For additional information and resources, visit Ontario Health’s HPV Hub.
Conclusion
The transition to HPV testing marks a significant advancement in cervical cancer prevention, providing earlier detection and reducing unnecessary testing. With OSCAR Pro’s updated eForms and workflow enhancements, physicians can easily integrate these changes into their practice, ensuring efficient documentation and compliance with new screening guidelines. By adapting to these updates, healthcare providers play a crucial role in improving patient outcomes and making cervical cancer a more preventable disease.
Have questions about the HPV screening update? Contact us today at help@oscarprodesk.ca.