Screening and diagnostic mammography updates from CMS

In a recent transmittal, Transmittal 791, the Centers for Medicare & Medicaid Services (CMS) published updated information on the reporting requirements for screening and diagnostic mammograms. HCPCS codes 76092 (screening mammography-film) and G0202 (screening mammography-digital) should not be billed together since only one type of screening mammography will be paid. Therefore, claims that reflect both a film screening mammography (76092) and a digital screening mammography ( G0202 ) should not be submitted on the same claim. Additionally, HCPCS codes 76090 or 76091 (diagnostic mammography-film) and G0204 or G0206 (diagnostic mammography-digital) should never be submitted on the same claim. CMS...

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Note:  The following article synopsis was NOT provided by the AHA. It was created by Find-A-Code/innoviHealth.

Article Overview

This article summarizes a CMS transmittal updating reporting requirements for screening and diagnostic mammography. It is aimed at billing staff, coders, and compliance teams that need to understand how Medicare claims processing, payment handling, and add-on service reporting are affected for mammography services.

Why This Topic Matters

Mammography billing rules can affect whether claims are paid, returned, or edited, so correct reporting is important for Medicare claim acceptance and reimbursement workflow. The article is relevant to providers and coders who work with mammography services under Medicare.

What You Will Learn

  • What CMS updated in its mammography reporting guidance
  • How the article frames screening versus diagnostic mammography billing updates
  • Which general Medicare payment systems are mentioned in connection with mammography reporting
  • How add-on service reporting is addressed in the transmittal context

Who Should Read This

  • Medical coders
  • Billing staff
  • Revenue cycle teams
  • Compliance professionals
  • Radiology practices
  • Medicare providers

Codes Discussed


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