Coverage Update for 3D Screening Mammograms

BCBSGA is updating its preventive care coverage to include screening digital breast tomosynthesis (DBT or 3D mammography) beginning June 6, 2017 for Individual, Small Group, and Large Group health plans. BCBSGA National Account plans will make this update beginning August 1, 2017. This means that 3D mammography for screening purposes will be covered at 100%, with no member cost share (copayments, deductibles, or coinsurance). Please note that because member benefits vary, providers should continue to verify eligibility and benefits for all members prior to rendering services or receiving member copayments, deductibles, or coinsurance. Additionally, cost-sharing requirements may still apply to preventive care services received from out-of-network providers.

The appropriate use of modifier 33 when billing for 3D mammography will reduce claim adjustments.

SOURCE: Network eUpdate 6/6/2017
INDUSTRY NEWS TAGS: Radiology News, BCBS Georgia

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