Claims Processing Instructions for Diagnostic Digital Breast Tomosynthesis

This change request (CR) provides claims processing instructions for HCPCS code G0279, defined “diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to G0204 or G0206).” Payment for HCPCS code G0279 will be permitted only when billed in conjunction with HCPCS code G0204 or G0206. A deductible and coinsurance will be applied to claim lines with HCPCS code G0279. Institutional and Professional billing TOB and Revenue guidelines are included in the CR.

Source: https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R3301CP.pdf