Screening Mammography

HCPCS/CPT Codes

  • 77063 - Screening digital breast tomosynthesis; bilateral (List separately in addition to code for primary procedure) (Use this as an add-on code to G0202 when tomosynthesis is used in addition to 2-D mammography)
  • 77067 - Screening mammography, bilateral (2-view film study of each breast) (Effective 01/01/18)
  • G0202 - Screening mammography, producing direct 2-D digital image, bilateral, all views (Valid prior to 01/01/18)

Frequency

  • Women aged 35 - 39: One baseline
  • Women 40 and over: Annually

Diagnosis Code

Z12.31 - Encounter for screening mammogram for malignant neoplasm of breast

Coverage

All females aged 35 and older

Facilities

  • Must be certified by Food and Drug Administration (FDA)
  • Cannot release x-rays for interpretation to physicians not approved under certification number unless:
    • Patient requested transfer for second opinion
    • Patient moved to another part of country where next screening mammography will be performed

Payment

Copayment/coinsurance waived; Deductible waived

Noridian Medicare Portal

Yes - 77057 and G0202

Resources

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