Breast Imaging Coding for Medicare in 2018

Breast Imaging Coding for Medicare in 2018

The Centers for Medicare & Medicaid Services (CMS) no longer requires use of dedicated G codes when reporting breast imaging services for Medicare beneficiaries, per MLN Matters Number: MM10181.

In 2017, the CPT® codebook deleted breast imaging codes 77051-77057 and replaced them with three new codes:

77065 Diagnostic mammography, including computer-aided detection (CAD) when performed; unilateral

77066 Diagnostic mammography, including computer-aided detection (CAD) when performed; bilateral

77067 Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed

The above codes (unlike their predecessors) includes computer-aided detection (CAD), when performed. CAD aids in the detection of breast cancer.

Medicare did not initially adopt the new CPT® codes. Instead, CMS required the use of dedicated G codes (G0202, G0204, G0206) throughout 2017 to describe breast imaging services for Medicare beneficiaries. Beginning Jan. 1, 2018, CMS has deleted the G codes, and instead allows reporting of CPT® codes 77065, 77066, 77067.

John Verhovshek

John Verhovshek

John Verhovshek, MA, CPC, is Managing Editor at AAPC. He has covered medical coding and billing, healthcare policy, and the business of medicine since 1999. He is an alumnus of York College of Pennsylvania and Clemson University, and a member of the Asheville-Hendersonville AAPC Local Chapter.
John Verhovshek

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John Verhovshek, MA, CPC, is Managing Editor at AAPC. He has covered medical coding and billing, healthcare policy, and the business of medicine since 1999. He is an alumnus of York College of Pennsylvania and Clemson University, and a member of the Asheville-Hendersonville AAPC Local Chapter.

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