Age Restriction and Gender Specification Updates for EWC Diagnosis Services

A NewsFlash article published in December 2016 announced the removal of age restrictions for Every Woman Counts (EWC) breast cancer diagnosis codes effective for dates of service on or after January 1, 2017. Additionally, effective retroactively for dates of service on or after January 1, 2017, in accordance with Assembly Bill 1795, EWC will provide breast diagnostic services to all symptomatic individuals regardless of identified gender. An Erroneous Payment Correction (EPC) will be implemented to reprocess affected claims. No action is required of providers.