According to LCD L36342, a diagnostic mammography is a radiologic procedure furnished to a man or woman with signs and symptoms of breast disease, personal history of breast cancer, or a personal history of biopsy-proven benign breast disease, and includes a physician’s interpretation of the results of the procedure.
Diagnostic mammogram(s) are allowed for the following indications:
The patient is under the care of the referring/ordering physician or qualified non-physician practitioner;
There are signs and/or symptoms suggestive of malignancy (mass, some types of spontaneous nipple discharge or skin changes);
There are possible radiographic abnormalities detected on screening mammography;
There is short interval follow-up (less than one year) necessary for unresolved clinical/radiographic concerns; or
Follow-up of established history of a malignancy is necessary
Diagnostic breast evaluation may be indicated in cases of a personal history of malignancy and in cases of benign biopsy-proven breast disease. These diagnoses should not, however, routinely warrant a diagnostic mammography.
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On March 31, 2020, CMS announced further changes to their telehealth program in response to this unprecedented public health emergency (PHE). The announcement included far more information than is presented in this article which only summarizes the changes to telehealth. In fact, it does change a little of the information included in our March 31st webinar.
On March 31, 2020, CMS announced further changes to their telehealth program in response to this unprecedented public health emergency (PHE). See this article for further information as well as references & links to CMS information
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