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Radiology Coding Alert

Mammography Update:

Re-Count the Months Between Screening Mammograms

Published on Thu Apr 08, 2004

In our April article "Performing DEXA or Mammography Too Often? Prepare an ABN," Radiology Coding Alert advised practices to schedule screening mammograms at least 366 days apart to avoid frequency denials. Recently, however, local Medicare carries have issued directives that allow screening mammograms (76092 , Screening mammography, bilateral [two-view film study of each breast]) a bit more frequently.
 
Blue Cross and Blue Shield of Kansas, for example, issued a policy update on Feb. 18 which states that carriers should base the patient's next annual screening mammography "beginning with the month after the month in which a screening mammography was performed and count until 11 full months have elapsed."

What to do: If you perform a screening mammogram in July 2004, you can perform your next screening mammogram as early as July 1, 2005.

You can read more about Medicare's screening mammography guidelines at the CMS Web site www.cms.hhs.gov/manuals/pm_trans/R25OTN.pdf.
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