Preventive Services: Screening Mammography

The following information from the Medicare Learning Network provides guidance from the Department of Health and Human Services on a Screening Mammography: 

HCPCS/CPT Codes

ICD-10 Codes

Z12.31

Who Is Covered

All female Medicare beneficiaries aged 35 and older

Frequency

• Aged 35 through 39: One baseline
• Aged 40 and older: Annually

Medicare Beneficiary Pays

• Copayment/coinsurance waived
• Deductible waived

Other Notes

• 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.

• CMS: Preventive Services Chart | Medicare Learning Network

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