September 1st, 2017
The following information from the Medicare Learning Network provides guidance from the Department of Health and Human Services on a Screening Mammography:
|77052 -||Computer-aided detection (computer algorithm analysis of digital image data for lesion detection) with further review for interpretation, with or without digitization of film radiographic images; screening mammography (List separately in addition to code for primary procedure)|
|77057 -||Screening mammography, bilateral (2-view study of each breast)|
|77063 -||Screeningdigitalbreasttomosynthesis; bilateral (List separately in addition to code for primary procedure)|
|G0202 -||Screening mammography, producing direct digital image, bilateral, all views|
Who Is Covered
All female Medicare beneficiaries aged 35 and older
- Aged 35 through 39: One baseline
- Aged 40 and older: Annually
Medicare Beneficiary Pays
- Copayment/coinsurance waived
- Deductible waived
- If billing a screening mammogram and a diagnostic mammogram on the same day, use modifier -GG to show a screening mammography turned into a diagnostic mammography.
Please note: The information in this educational product applies only to the Medicare Fee-For-Service Program (also known as Original Medicare). For additional guidance on using diagnosis codes, go to the Medicare Claims Processing Manual, Chapter 18 on the Centers for Medicare & Medicaid Services (CMS) website.
Watch the CMS Provider Minute: Preventive Services video for pointers to help you submit sufficient documentation when billing for certain preventive services.