Mammography Services for Medicare

Welcome to CMS web page for Mammography Services for Medicare. The intent of this web page is to put mammography-specific information for Medicare in once place for the provider/supplier community. We will continue to add information to this page as it becomes available. We will continue to improve both functionality and formatting to make the page more user-friendly.

Highlights

There are no highlights at this time. As new information is presented, it will appear in this highlight section, so check back often.

Coding

HCPCS and Diagnosis Codes (adobe pdf 84Kb) - Excerpts copied from Pub 100-4, Chapter 18, Section 20.2
Modifiers (adobe pdf 58Kb) - Excerpts copied from Pub 100-4, Chapter 18, Section 20.2

Policies/Regulations

Basic Coverage Rules - Excerpts from Pub 100-2, Chp. 15, Sec.280.3, Pub 100-4, Chp. 18, Sec. 20.2
Social Security Act
- Screening Mammography - Defined in Section 1861(jj)
- Payment and Standards for Screening Mammography - Section 1834(c)
Interpreting the 12-Month Rule (FAQ)

CMS Online Manual

CMS Manual System (Internet-Only Manuals) -- Effective October 1, 2003, CMS transitioned from a paper-based to a web-based manual system.
Mammography Manual References
- Claims Processing (Section 20)
- Skilled Nursing Facility (Section 80.2)
- Benefit Policy (Section 280.3)
Mammography Transmittals -- Program transmittals are used to communicate new or changed policies, and/or procedures that are being incorporated into a specific CMS program manual. The cover page (or transmittal page) summarizes the new changed material, specifying what is changed.
2003 Program Memoranda -- Effective October 1, 2003, program memoranda (PMs) will no longer be issued to transmit new Medicare & Medicaid policies and procedures.

Resources

Education

Medlearn Matters - articles are intended to explain, or clarify, PMs (pre-10/1/03) and CRs (10/1/03-present)
Medicare Learning Network (Medlearn) Internet Only Manual Initiative -- This education webpage is designed to provide a wealth of information on the October 1, 2003 CMS transition from a paper-based manual system to a Web-based system.

Contacts

Regional Office Contacts (adobe pdf 99Kb)

CMS Regional Office Directory

Contact your Carrier/FI via Toll-Free Numbers and Websites -- A listing of the new toll-free numbers that CMS has installed at Medicare contractor sites

How To Stay Informed

General Information for Providers and Suppliers

Much of the information found in the General Information section can also be found on the individual Provider and Supplier web pages (e.g., provider enrollment, HIPAA compliance, coding, medical review, etc.).

Note: Some of the files on this page are available only in Adobe Acrobat - Portable Document Format (PDF). To view PDF files, you must have the Adobe Acrobat Reader (minimum version 5, version 6 suggested). You can check here to see if you have the Acrobat Reader installed on your computer. If you do not already have the Acrobat Reader installed, please go to Adobe's Acrobat download page now.

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