Medicare_Claims_Processing_Manual / Chapter_18 / 20.2

Why This Topic Matters

Mammography claims are sensitive to date-specific Medicare billing requirements and diagnosis reporting rules. Understanding the scope of this guidance helps reduce claim processing errors and supports accurate submission under the referenced Medicare instructions.

Article Sections

1. HCPCS and diagnosis codes for mammography services

   Introduces the Medicare billing context for mammography services and notes that a chart of applicable billing codes is referenced in the source material.

2. Diagnosis for services on or after January 1, 1998

   Summarizes the diagnosis-code reporting framework for screening mammography claims during the post-1997 period and includes related claims-processing notes.

3. Diagnoses for services October 1, 1997 through December 31, 1997

   Describes the earlier date-specific diagnosis reporting framework for screening mammography and identifies the broad high-risk categories addressed in the guidance.