The CMS.gov Web site currently does not fully support browsers with Reproduced by CMS with permission. Medicare will cover 80 percent of the cost of this type of mammogram, while you will be responsible for the other 20 percent and the Part B deductible. Colonoscopies. Revenue codes only apply to providers who bill these services to the Part A MAC. You would be responsible for the remaining 20 percent. At VibrantUSA, it’s our mission to find the best Medicare plans at the lowest prices for our clients. For screening mammography code 77067, 77063. All rights reserved. Cancer, including breast, lung, brain, and other types, is the number 2 cause of death in the United States behind heart disease. The provider/supplier must notify the beneficiary in writing, prior to rendering the service, if the provider/supplier is aware that the test, item or procedure may not be covered by Medicare. covers: One baseline mammogram if you're a woman between ages 35-39. An asterisk (*) indicates a required field. (Make a selection to complete a short survey). Medicare covers one baseline mammogram for women between the ages of 35 and 39. To license the electronic data file of UB-04 Data Specifications, contact Tim Carlson at (312) 893-6816. Overview . There are different article types: Articles are often related to an LCD, and the relationship can be seen in the âAssociated Documentsâ section of the Article or the LCD. AHA copyrighted materials including the UB-04 codes and descriptions may not be removed, copied, or utilized within any software, product, service, solution or A radiological mammogram is a covered diagnostic test under the following conditions: The patient’s medical record should include but is not limited to: A clear, clinical indication for the diagnostic mammogram/breast sonogram/breast MRI/ductogram must be documented in the medical record, as well as in the referral order. What makes breast cancer so deadly is the proximity to the lymphatic system. Found inside – Page 64Identifying characteristics of older Medicare women who do not obtain regular mammography screening or who have never had ... minate regular mammography screening and some demographic characteristics ( age , race , Medicaid coverage ) . Therefore, if a drug is self-administered by more than 50 percent of Medicare beneficiaries, the drug is excluded from coverage" and the MAC will make no payment for the drug. HCPCS codes C8903 through C8908 are to be billed to the Part A MAC and not the Carrier or Part B MAC. You can use the Contents side panel to help navigate the various sections. No fee schedules, basic unit, relative values or related listings are included in CPT. 80 percent of necessary diagnostic mammogram costs. End User License Agreement: Please review and accept the agreements in order to view Medicare Coverage documents, which may include licensed information and codes. AMA warrants that due to the nature of CPT, it does not manipulate or process dates, therefore there is no Year 2000 issue with CPT. Medicare covers as many diagnostic mammograms as necessary. The provider/supplier must notify the beneficiary in writing, prior to rendering the service, if the provider/supplier is aware that the test, item or procedure may not be covered by Medicare. Federal government websites often end in .gov or .mil. CMS Limitations Guide - Mammography & Bone Mass Measurement (NCD 220.4) Diagnostic Mammography Diagnostic Mammogram (G0206) ICD-10 Codes That Support Medical Necessity and Covered by Medicare Program: For codes in the table below that require a 7th character, letter A initial encounter, D subsequent encounter or S sequela may be used. Scene of Accident), Magnetic Resonance Technology (MRT) - MRI - Other, Some older versions have been archived. Your costs may be different for a diagnostic mammogram if you have a Medicare Advantage plan. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material. Medicare Supplement: With Original Medicare and a supplemental policy, you will not pay the 20% coinsurance for a diagnostic mammogram. Billing and Coding articles typically include CPT/HCPCS procedure codes, ICD-10-CM diagnosis codes, as well as Bill Type, Revenue, and CPT/HCPCS Modifier codes. Starting at age 35, your Medicare Part B plan will pay the entirety of the cost for either an initial baseline mammogram or a yearly screening mammogram.. Applications are available at the AMA Web site, http://www.ama-assn.org/cpt. The third edition of Changing the U.S. Health Care System is a thoroughly revised and updated compendium of the most current thought on three key components of health care policy—improving access, ensuring quality, and controlling costs. product or publication; creating any modified or derivative work of the UB-04 Manual and/or codes and descriptions; and/or making any commercial use of UB-04 No. This page displays your requested Article. A diagnostic mammogram is sometimes indicated when a screening mammogram shows possible signs of cancer, or when your doctor has other reasons to suspect cancer. Found inside – Page 13Low-cost Services Do Not Compromise Quality, Report to Congressional Committees United States. General Accounting Office. Introduction Medicare Benefit for Screening Mammography Proposed Currently , Medicare covers diagnostic ... Instructions for enabling "JavaScript" can be found here. Mammogram is the only screening test for breast cancer that has a $0 price tag. Medicare and Mammogram Screenings. Refer to NCCI and OPPS requirements prior to billing Medicare. Draft articles are articles written in support of a Proposed LCD. This book presents the current trends and practices in breast imaging. complete information, CMS does not guarantee that there are no errors in the information displayed on this web site. Similarly, not all revenue codes apply to each CPT/HCPCS code. "JavaScript" disabled. While every effort has been made to provide accurate and Please note that not all revenue codes apply to every type of bill code. Medicare covers mammograms for women age 35 and over. Also, you can decide how often you want to get updates. Does Medicare Cover Diagnostic Mammograms? that coverage is not influenced by Bill Type and the article should be assumed to Medicare does cover 3D mammograms with no additional cost to you beyond coinsurance and deductible amounts that may apply to a diagnostic mammogram. Applications are available at the American Dental Association web site. The –GA modifier (“Waiver of Liability Statement Issued as Required by Payer Policy”) should be used when physicians, practitioners, or suppliers want to indicate that they anticipate that Medicare will deny a specific service as not reasonable and necessary and they do have an ABN signed by the beneficiary on file. As an independent agency, we’re able to provide this service at no cost, meaning we can find the best plans for our clients. There are 2 types of mammograms: screening and diagnostic. One of the many preventive services that are covered by Medicare are mammograms. As a Medicare beneficiary, you will pay nothing for yearly mammograms. If the service is statutorily non-covered, or without a benefit category, submit the appropriate CPT/HCPCS code with the -GY modifier. Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. Common gasses or chemicals that cause cancer are asbestos, benzene, radon, and others. To compile this text, we assembled experts from throughout the world. Thus, this text provides not only a broad overview of breast diseases, but also highlights diff- ent perspectives from different parts of the world. If the examination began as a screening mammogram and additional films were ordered based on abnormal results, the specific abnormality must be documented in the record. Medicare Part B or a Medicare Advantage plan should cover 100% of yearly screening mammogram costs and 80 percent of necessary diagnostic mammogram costs. While you have some coverage with Original Medicare Parts A and B, a supplemental Medicare plan such as a Medicare Advantage or Medigap plan may help . The limitation of liability and refund requirements do not apply when the test, item or procedure is statutorily excluded, has no Medicare benefit category or is rendered for screening purposes. As long as the study is considered medically necessary, Medicare will cover it. Refer to CMS Publication 100-04, Medicare Claims Processing Manual, Chapter 30, for complete instructions. Applicable FARS\DFARS Restrictions Apply to Government Use. The responsibility for the content of this file/product is with CMS and no endorsement by the AMA is intended or implied. A diagnostic mammography is a covered service if it is ordered by a doctor of medicine or osteopathy as defined in §1861(r) (1) of the Act. Of those diagnosed with breast cancer, an estimated 43,600 will die from the disease. Medicare Part B (Medical Insurance) Part B covers certain doctors' services, outpatient care, medical supplies, and preventive services. Baseline mammogram screenings are covered as part of your Original Medicare coverage. (Some people with disabilities are eligible for Medicare even if they are under age 65.) Many preventive services are covered at 100 percent (at no out-of-pocket cost to you). If you have Medicare Part B or Medicare Advantage, coverage for mammograms includes: 100 percent of yearly screening mammogram costs. Medicare does not cover preventive mammograms for men. That means there are no out-of-pocket costs once you are a certain age. This book offers a single publication to be utilised comprehensively as a reference manual within current mammographic clinical practice for use by assistant practitioners and practitioners as well as trainees in radiography and related ... Since September 2010, the Affordable Care Act has required all new health insurance plans to cover screening mammograms, with no co-payment [].Health plans must cover mammography every 2 years for women 50 and older, and as recommended by a health care provider for women 40-49 []. This book provides a comprehensive and meaningful picture of this oncological area, including epidemiology, histopathology, staging, genetic predisposition, sexual function, fertility, treatment and management, survivorship, and palliative ... A diagnostic mammogram may be recommended when a screening mammogram shows an abnormality or when a physical exam reveals a lump. Refer to the Indications and Limitations section of the LCD. Neither the United States Government nor its employees represent that use of such information, product, or processes It will help if you used a Medicare-approved provider, also valid for Medicare Advantage Plans if you meet Medicare requirements. One screening mammogram every 12 months for women age 40 and older; One baseline mammogram for women ages 35-39; Additional diagnostic mammograms that are considered medically necessary may be covered for women of any age; Screening mammograms are covered in full by Medicare Part B, while women . Effective April 1, 2010, Part A MAC systems will automatically deny services billed with modifier GA. An ABN, Form CMS-R-131, should be signed by the beneficiary to indicate that he/she accepts responsibility for payment. The -GA modifier may also be used on assigned claims when a patient refuses to sign the ABN and the latter is properly witnessed. The Dartmouth Atlas project is a funded research effort of the faculty of the Center for the Evaluative Clinical Sciences at Dartmouth Medical School. If you are a Medicare beneficiary between the ages of 35 and 39, Part B will generally cover the allowable charges for one baseline mammogram prior to age 40. Diagnostic mammograms more frequently than once a year, if. If you have any questions about mammogram coverage, Original Medicare, what Medicare Advantage Plans cover, or when enrollment periods are, please don’t hesitate to contact us. will not infringe on privately owned rights. Revision Explanation: Converted article into new Billing and Coding template no other changes made. Washington Healthplanfinder’s 2022 Open Enrollment Period Is Here, Independent Medicare Insurance Agency Locations. Please note that if you choose to continue without enabling "JavaScript" certain functionalities on this website may not be available. Radiologic Diagnostic Procedures - Medicare Advantage Coverage Summary CT scans. 77046, 77048 (effective 01/01/2019)77058 (end dated 12/31/2018), 77047, 77049 (effective 01/01/2019)77059 (end dated 12/31/2018). Revenue codes do not apply to physicians, other professionals and suppliers who bill these services to the carrier or Part B MAC. Screening mammograms have 100% coverage for members who qualify for Part A and B. For cervical cancer, Medicare covers the following services: A Pap smear These can be found in the workplace or even naturally occurring at home depending on its construction or location. Medicare does cover mammograms for women aged 65-69. For some women, their mammogram screening will require more diagnostic testing. Medicare provides for coverage of diagnostic and screening mammograms, as outlined in the CMS National Coverage Determination (NCD) for Mammograms. The diagnosis code(s) must best describe the patient's condition for which the service was performed. The Part B deductible would also apply. Article - Billing and Coding: Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography (A56448). Medicare does cover mammograms for women aged 65-69. If your doctor determines it to be medically necessary, Medicare will also cover diagnostic mammograms more frequently . CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CPT. This additional care is considered diagnostic, meaning your provider is treating you because of certain symptoms or risk factors. Found inside – Page 91Most insurance policies do not cover screening mammograms which can detect problems at the earliest and most curable stage , even though physicians recommend that women over 40 get mammograms once a year . Diagnostic mammograms used ... It can strike at any time and affects men and women of all ages. Medicare will cover breast ultrasound for diagnostic purposes when it is medically necessary. Medicare covers screening mammography for women age 40 and over on a once per calendar year basis. Providers are encouraged to refer to the FISS HCPCS file for allowable revenue codes. Fortunately, we know about many causes and can take steps to mitigate the interaction. an effective method to share Articles that Medicare contractors develop. All Rights Reserved. Current Dental Terminology © 2020 American Dental Association. Medicare Part B covers mammograms in the following ways:. At what age are mammograms no longer needed? You pay nothing for the test if the doctor or other qualified health care provider accepts assignment. A clear, clinical indication for the diagnostic mammogram/breast sonogram/breast MRI/ductogram must be documented in the medical record, as well as in the referral order. The Centers for Medicare & Medicaid Services (CMS), the federal agency responsible for administration of the Medicare, Aetna considers diagnostic mammography medically necessary for members with signs or symptoms of breast disease or history of breast cancer. Mammograms are the best way to find breast cancer early when it is easier to treat and before it is big enough to feel or cause symptoms. Providers are encouraged to refer to the FISS revenue code file for allowable bill types. If you aren't at high risk for colorectal cancer, Medicare covers the test once every 120 months, or 48 months after a previous flexible sigmoidoscopy. (Exception: Institutional Special Needs Plans and Group Retiree plans may apply radiologic diagnostic cost sharing.) The AMA is a third party beneficiary to this Agreement. Assessing and Improving the Interpretation of Breast Images summarizes the presentations and discussions from this workshop. MACs are Medicare contractors that develop LCDs and Articles along with processing of Medicare claims. Medicare contractors are required to develop and disseminate Articles. It is the responsibility of the provider to code to the highest level specified in the ICD-10-CM. Diagnostic mammograms are used if you have suspicious or concerning results from your annual mammogram. Diagnostic mammograms are covered more frequently when medically necessary, although deductibles and copays may apply. Medicare Part B covers mammograms. Use of CDT is limited to use in programs administered by Centers for Medicare & Medicaid Services (CMS). CPT is provided âas isâ without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. This Agreement will terminate upon no upon notice if you violate its terms. You pay 20% of the allowable charges and your Part B deductible applies. Building on the 2001 report Mammography and Beyond, this new book not only examines ways to improve implementation and use of new and current breast cancer detection technologies but also evaluates the need to develop tools that identify ... You agree to take all necessary steps to ensure that your employees and agents abide by the terms of this agreement. Original Medicare will cover many of the treatments you will . Patients will need to pay 20% of the fee. Revision Explanation: New code N63.15 and N63.2 were added to ICD-10 group 2 and 3 during the annual ICD-10 update. Organizations who contract with CMS acknowledge that they may have a commercial CDT license with the ADA, and that use of CDT codes as permitted herein for the administration of CMS programs does not extend to any other programs or services the organization may administer and royalties dues for the use of the CDT codes are governed by their commercial license. The service must be reasonable and necessary in the specific case and must meet the criteria specified in this determination.For screening mammography code 77067, 77063, 77065, 77066 For diagnostic mammography and screening mammography that converts to diagnostic mammography (codes 77065, 77066, or G0279). Any questions pertaining to the license or use of the CPT should be addressed to the AMA. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not Medicare covers a free mammogram screening each year for women 40 and older at no cost. If it's a diagnostic, Medicare will not cover it. You may also contact us at ub04@aha.org. "JavaScript" disabled. If it's a diagnostic, Medicare will not cover it. Public Health derivative work without the written consent of the AHA. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. By clicking below on the button labeled âI acceptâ, you hereby acknowledge that you have read, understood and agreed to all terms and conditions set forth in this agreement. Screening mammograms once every 12 months if you're a woman age 40 or older. What Medicare covers for diagnostic mammograms. The AMA does not directly or indirectly practice medicine or dispense medical services. For claims submitted to the Part A MAC, occurrence code 32 and the date of the ABN is required. This process is known as metastasis. This comprehensive guide covers all aspects of mastopexy and breast reduction, ranging from anatomy to the variety of procedures in mastopexy, mastopexy/breast reduction, and breast reduction, preoperative care, complications, breast tumors ... The 3D mammogram is a diagnostic mammogram, but many oncologists militate against it. Annual screening mammograms have 100% coverage. services. In most instances Revenue Codes are purely advisory. Found insideScreening Mammograms : Since January 1 , 1991 , Medicare has covered mammography screening for the early detection ... Medicare also covers diagnostic mammograms when the patient shows signs or symptoms of breast disease , or a personal ... Instructions for enabling "JavaScript" can be found here. Specifically, this book provides recommendations aimed at improving mammography interpretation; revising MQSA regulations, inspections, and enforcement; ensuring an adequate workforce for breast cancer screening and diagnosis; and improving ... Medicare covers as many diagnostic mammograms as necessary. Medicare Part B also covers one or more diagnostic mammograms if it is necessary to diagnose breast cancer. If a person visits an in-network provider, the plan pays part of the cost, but deductibles . Medicare does not always pay for diagnostic tests. Medicare pays 80% of the cost of diagnostic mammograms. A diagnostic screening uses an x-ray image of the breast to investigate any abnormalities found during the other screenings. However, Medicare does cover diagnostic mammograms for men and women. apply equally to all claims. Medicare . Medicare covers both screening and diagnostic mammograms, but coverage varies depending on the type of mammogram you are receiving. Providers are encouraged to refer to the FISS revenue code file for allowable bill types. With MA plans you still have the free preventive exam. A claim submitted without a valid ICD-10-CM diagnosis code will be returned to the provider as an incomplete claim under Section 1833(e) of the Social Security Act. THE UNITED STATES Your MCD session is currently set to expire in 5 minutes due to inactivity. If you have Medicare Part B or Medicare Advantage, coverage for mammograms includes: 100 percent of yearly screening mammogram costs. Medicare Part B, which covers outpatient services, pays 100% for a screening mammogram — an imaging technique that can detect some breast cancers — every 12 months for women age 40 or older. This book offers a comprehensive, practical resource entirely devoted to Contrast-Enhanced Digital Mammography (CEDM), a state-of-the-art technique that has emerged as a valuable addition to conventional imaging modalities in the detection ... Mammograms do not cause breast cancer. Get a Free 2022 Open Enrollment Guide. Since 2003, it’s been our business helping people just like you make sense of Medicare insurance. The criteria for mammogram screenings are: Between ages 35-39, Medicare covers one baseline mammogram. Annual screening mammograms have 100% coverage. Found inside – Page 108The definition of “ diagnostic services ” mentioned above also establishes that Medicare Part B covers diagnostic x - ray tests including diagnostic mammography if conducted by a facility that has a certificate under the Public Health ... You, your employees and agents are authorized to use CPT only as contained in the following authorized materials of CMS internally within your organization within the United States for the sole use by yourself, employees and agents. You acknowledge that the ADA holds all copyright, trademark and other rights in CDT. Screening and diagnostic mammograms. You can get one baseline mammogram between ages 35 and 39, too. $0 copayment in-network for diagnostic mammograms. The correct use of an ICD-10-CM code listed below does not assure coverage of a service. An innovative, three-dimensional x-ray imaging technique that enhances projection radiography by adding depth resolution, Tomosynthesis Imaging explores tomosynthesis, an emerging limited-angle tomographic imaging technology that is being ... As long as you are eligible, you may receive a mammogram screening. This is why there are no frequency limits on diagnostic mammograms. CMS believes that the Internet is You agree to take all necessary steps to insure that your employees and agents abide by the terms of this agreement. If you are acting on behalf of an organization, you represent that you are authorized to act on behalf of such organization and that your acceptance of the terms of this agreement creates a legally enforceable obligation of the organization. ICD-10-CM Codes that Support Medical Necessity, ICD-10-CM Codes that DO NOT Support Medical Necessity, L33950 - Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography, INJECTION PROCEDURE ONLY FOR MAMMARY DUCTOGRAM OR GALACTOGRAM, ULTRASOUND, BREAST, UNILATERAL, REAL TIME WITH IMAGE DOCUMENTATION, INCLUDING AXILLA WHEN PERFORMED; COMPLETE, ULTRASOUND, BREAST, UNILATERAL, REAL TIME WITH IMAGE DOCUMENTATION, INCLUDING AXILLA WHEN PERFORMED; LIMITED, MAGNETIC RESONANCE IMAGING, BREAST, WITHOUT CONTRAST MATERIAL; UNILATERAL, MAGNETIC RESONANCE IMAGING, BREAST, WITHOUT CONTRAST MATERIAL; BILATERAL, MAGNETIC RESONANCE IMAGING, BREAST, WITHOUT AND WITH CONTRAST MATERIAL(S), INCLUDING COMPUTER-AIDED DETECTION (CAD REAL-TIME LESION DETECTION, CHARACTERIZATION AND PHARMACOKINETIC ANALYSIS), WHEN PERFORMED; UNILATERAL, MAGNETIC RESONANCE IMAGING, BREAST, WITHOUT AND WITH CONTRAST MATERIAL(S), INCLUDING COMPUTER-AIDED DETECTION (CAD REAL-TIME LESION DETECTION, CHARACTERIZATION AND PHARMACOKINETIC ANALYSIS), WHEN PERFORMED; BILATERAL, MAMMARY DUCTOGRAM OR GALACTOGRAM, SINGLE DUCT, RADIOLOGICAL SUPERVISION AND INTERPRETATION, MAMMARY DUCTOGRAM OR GALACTOGRAM, MULTIPLE DUCTS, RADIOLOGICAL SUPERVISION AND INTERPRETATION, SCREENING DIGITAL BREAST TOMOSYNTHESIS, BILATERAL (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE), DIAGNOSTIC MAMMOGRAPHY, INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PERFORMED; UNILATERAL, DIAGNOSTIC MAMMOGRAPHY, INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PERFORMED; BILATERAL, SCREENING MAMMOGRAPHY, BILATERAL (2-VIEW STUDY OF EACH BREAST), INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PERFORMED, MAGNETIC RESONANCE IMAGING WITH CONTRAST, BREAST; UNILATERAL, MAGNETIC RESONANCE IMAGING WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, BREAST; UNILATERAL, MAGNETIC RESONANCE IMAGING WITH CONTRAST, BREAST; BILATERAL, MAGNETIC RESONANCE IMAGING WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, BREAST; BILATERAL, DIAGNOSTIC DIGITAL BREAST TOMOSYNTHESIS, UNILATERAL OR BILATERAL (LIST SEPARATELY IN ADDITION TO 77065 OR 77066), Encounter for screening mammogram for malignant neoplasm of breast, Malignant neoplasm of nipple and areola, right female breast, Malignant neoplasm of nipple and areola, left female breast, Malignant neoplasm of nipple and areola, right male breast, Malignant neoplasm of nipple and areola, left male breast, Malignant neoplasm of central portion of right female breast, Malignant neoplasm of central portion of left female breast, Malignant neoplasm of central portion of right male breast, Malignant neoplasm of central portion of left male breast, Malignant neoplasm of upper-inner quadrant of right female breast, Malignant neoplasm of upper-inner quadrant of left female breast, Malignant neoplasm of upper-inner quadrant of right male breast, Malignant neoplasm of upper-inner quadrant of left male breast, Malignant neoplasm of lower-inner quadrant of right female breast, Malignant neoplasm of lower-inner quadrant of left female breast, Malignant neoplasm of lower-inner quadrant of right male breast, Malignant neoplasm of lower-inner quadrant of left male breast, Malignant neoplasm of upper-outer quadrant of right female breast, Malignant neoplasm of upper-outer quadrant of left female breast, Malignant neoplasm of upper-outer quadrant of right male breast, Malignant neoplasm of upper-outer quadrant of left male breast, Malignant neoplasm of lower-outer quadrant of right female breast, Malignant neoplasm of lower-outer quadrant of left female breast, Malignant neoplasm of lower-outer quadrant of right male breast, Malignant neoplasm of lower-outer quadrant of left male breast, Malignant neoplasm of axillary tail of right female breast, Malignant neoplasm of axillary tail of left female breast, Malignant neoplasm of axillary tail of right male breast, Malignant neoplasm of axillary tail of left male breast, Malignant neoplasm of overlapping sites of right female breast, Malignant neoplasm of overlapping sites of left female breast, Malignant neoplasm of overlapping sites of right male breast, Malignant neoplasm of overlapping sites of left male breast, Secondary and unspecified malignant neoplasm of axilla and upper limb lymph nodes, Secondary malignant neoplasm of right lung, Secondary malignant neoplasm of left lung, Secondary malignant neoplasm of mediastinum, Secondary malignant neoplasm of liver and intrahepatic bile duct, Secondary malignant neoplasm of bone marrow, Disseminated malignant neoplasm, unspecified, Malignant (primary) neoplasm, unspecified, Lobular carcinoma in situ of right breast, Intraductal carcinoma in situ of right breast, Intraductal carcinoma in situ of left breast, Other specified type of carcinoma in situ of right breast, Other specified type of carcinoma in situ of left breast, Neoplasm of uncertain behavior of right breast, Neoplasm of uncertain behavior of left breast, Phlebitis and thrombophlebitis of other sites, Diffuse cystic mastopathy of right breast, Other benign mammary dysplasias of right breast, Other benign mammary dysplasias of left breast, Unspecified lump in the right breast, upper outer quadrant, Unspecified lump in the right breast, upper inner quadrant, Unspecified lump in the right breast, lower outer quadrant, Unspecified lump in the right breast, lower inner quadrant, Unspecified lump in the right breast, overlapping quadrants, Unspecified lump in the left breast, upper outer quadrant, Unspecified lump in the left breast, upper inner quadrant, Unspecified lump in the left breast, lower outer quadrant, Unspecified lump in the left breast, lower inner quadrant, Unspecified lump in the left breast, overlapping quadrants, Unspecified lump in axillary tail of the right breast, Unspecified lump in axillary tail of the left breast, Unspecified lump in right breast, subareolar, Unspecified lump in left breast, subareolar, Fissure and fistula of nipple - Mastodynia, Induration of breast - Retraction of nipple, Mammographic microcalcification found on diagnostic imaging of breast, Mammographic calcification found on diagnostic imaging of breast, Other abnormal and inconclusive findings on diagnostic imaging of breast, Contusion of right breast, initial encounter, Contusion of left breast, initial encounter, Laceration without foreign body of right breast, initial encounter, Laceration without foreign body of left breast, initial encounter, Laceration with foreign body of right breast, initial encounter, Laceration with foreign body of left breast, initial encounter, Puncture wound without foreign body of right breast, initial encounter, Puncture wound without foreign body of left breast, initial encounter, Puncture wound with foreign body of right breast, initial encounter, Puncture wound with foreign body of left breast, initial encounter, Open bite of right breast, initial encounter, Open bite of left breast, initial encounter, Complete traumatic amputation of right breast, initial encounter, Complete traumatic amputation of left breast, initial encounter, Partial traumatic amputation of right breast, initial encounter, Partial traumatic amputation of left breast, initial encounter, Breakdown (mechanical) of breast prosthesis and implant, initial encounter, Displacement of breast prosthesis and implant, initial encounter, Leakage of breast prosthesis and implant, initial encounter, Capsular contracture of breast implant, initial encounter, Other mechanical complication of breast prosthesis and implant, initial encounter, Encounter for observation for other suspected diseases and conditions ruled out, Encounter for follow-up examination after completed treatment for malignant neoplasm, Encounter for follow-up examination after completed treatment for conditions other than malignant neoplasm, Contact with and (suspected) exposure to other environmental pollution, Contact with and (suspected) exposure to radon and other naturally occurring radiation, Contact with and (suspected) exposure to other hazards in the physical environment, Contact with and (suspected) exposure to environmental tobacco smoke (acute) (chronic), Other contact with and (suspected) exposures hazardous to health, Personal history of malignant neoplasm of breast, Personal history of malignant neoplasm of soft tissue, Personal history of malignant neoplasm of other organs and systems, Personal history of other medical treatment, Personal history of breast implant removal, Malignant neoplasm of unspecified site of right female breast, Malignant neoplasm of unspecified site of left female breast, Malignant neoplasm of unspecified site of right male breast, Malignant neoplasm of unspecified site of left male breast, Unspecified type of carcinoma in situ of right breast, Unspecified type of carcinoma in situ of left breast, Neoplasm of unspecified behavior of bone, soft tissue, and skin, Neoplasm of unspecified behavior of breast, Fissure and fistula of nipple - Galactorrhea not associated with childbirth, Mammographic microcalcification found on diagnostic imaging of breast - Inconclusive mammogram, Hospital Inpatient (Medicare Part B only), Skilled Nursing - Inpatient (Medicare Part B only), Clinic - Federally Qualified Health Center (FQHC), Other Imaging Services - Diagnostic Mammography, Other Imaging Services - Screening Mammography, Other Imaging Services - Other Imaging Services, Freestanding Clinic - General Classification, Freestanding Clinic - Clinic Visit by Member to RHC/FQHC, Freestanding Clinic - Home Visit by RHC/FQHC Practitioner, Freestanding Clinic - Visit by RHC/FQHC Practitioner to a Member in a SNF or Skilled Swing Bed in a Covered Part A Stay, Freestanding Clinic - Visit by RHC/FQHC Practitioner to a Member in a SNF (not in a Covered Part A Stay) or NF or ICF MR or Other Residential Facility, Freestanding Clinic - Visiting Nurse Service(s) to a Member's Home when in a Home Health Shortage Area, Freestanding Clinic - Visit by RHC/FQHC Practitioner to Other non-RHC/FQHC site (e.g.
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