Medicare_Claims_Processing_Manual / CMS 100-04, Change Request 6023

Why This Topic Matters

Mammography claims are subject to specific Medicare processing and billing rules, and this guidance affects how claims are submitted, edited, and routed for payment or denial. Understanding the manual update helps providers and contractors apply the correct administrative workflow and stay aligned with CMS instructions.

Article Sections

1. Business Requirements Table

   Administrative requirements and contractor responsibilities associated with the change request.

2. Provider Education Table

   Distribution and posting expectations for related provider education materials and contractor communication.

3. Supporting Information

   Reference space for requirement cross-references and supplemental notes.

4. Contacts

   CMS contact information for pre-implementation and post-implementation questions.

5. Funding

   Statements describing funding and contract-direction provisions for Medicare contractors.

6. Chapter 18 - Preventive and Screening Services

   Manual content governing preventive and screening service processing within Medicare claims administration.

7. 20.4 - Billing Requirements – FI/A/B MAC Claims

   Billing and processing instructions for mammography claims handled by fiscal intermediaries and A/B MACs.

8. 20.5 - Carrier Processing Requirements

   Carrier-side processing instructions for mammography claims, including claim routing and related administrative edits.

9. Carrier Provider Education

   Provider-facing education points tied to mammography claim submission and related billing scenarios.