AHA Coding Clinic® for HCPCS - 2005 Issue 1; FOR your INFORMATION

Diagnostic mammography no longer paid under OPPS

A change in payment structure for diagnostic mammography, including diagnostic computer aided detection (CAD) services that are furnished by hospitals subject to OPPS became effective January 1, 2005. Provision for this payment modification can be found in Section 614 of the Medicare Prescription Drug Improvement, and Modernization Act (MMA) of 2003. On or after January 1, 2005 Medicare will pay for diagnostic mammography and CAD services based on the Medicare Physician Fee Schedule. Payment for the diagnostic mammography is no longer payable under the OPPS. This information was published by CMS in Transmittal 385. ...

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