CAD Billing Charts (Rev. 1070, 01-02-07)

by  Jared Staheli
June 25th, 2015

The following chart provides guidance for billing of CAD add-on codes. It reflects appropriate coding combinations that may be billed and the time frames associated with each.

Chart I – Screening CAD Codes

CAD Codes Effective 01-01-02 thru 03-31-03 Effective 04-01-03 thru 12-31-03 Effective 01-01-04 thru 12-31-06 Effective 01-01-07 and later
76085 76092 76092, G0202 N/A N/A
76083 N/A N/A 76092, G0202 N/A
77052 N/A N/A N/A 77057, G0202

Chart II – Diagnostic CAD Codes

CAD Codes Effective 01-01-02 thru 03-31-03 Effective 04-01-03 thru 12-31-03 Effective 01-01-04 thru 12-31-06 Effective 01-01-07 and later
G0236 76090 76090 N/A N/A
  76091 76091    
    G0204    
    G0206    
76082 N/A N/A 76090 N/A
      76091 N/A
      G0204 N/A
      G0206 N/A
77051 N/A N/A N/A G0204
        G0206
        77055
        77056

*For claims with dates of service prior to January 1, 2007, providers report CPT codes 76090, 76091, G0204 or G0206 with 76082. For claims with dates of service January 1, 2007 and later, providers report CPT codes 77055, 77056, G0204, or G0206 with 77051, respectively.

The CWF Application of Age and Frequency Edits,--The following chart reflects proper application of CWF age and frequency edits applied to CAD HCPCS codes billed in conjunction with screening mammographies HCPCS codes.

CAD Codes Effective 01-01-02 thru 03-31-03 Effective 04-01-03 thru 12-31-03 Effective 01-01-04 thru 12-31-06 Effective 01-01-07 and later
76085 76092 76092, G0202 N/A N/A
76083 N/A N/A 76092, G0202 N/A
77052 N/A N/A N/A 77057, G0202

See section 20.5.1, for carrier CWF edits

*For claims with dates of service prior to January 1, 2007, providers report CPT codes 76083 and 76092. For claims with dates of service January 1, 2007 and later, providers report CPT codes 77052 and 77057 respectively.

References:

CAD Billing Charts (Rev. 1070, 01-02-07). (2015, June 25). Find-A-Code Articles. Retrieved from https://www.findacode.com/articles/cad-billing-charts-rev-1070-01-02-07-26928.html

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