CMS issues correction notice affecting new tomosynthesis code

Twitter icon
Facebook icon
LinkedIn icon
e-mail icon
Google icon
 - eraser error

The Centers for Medicare & Medicaid Services (CMS) has issued a notice correcting the 2015 MPFS Final Rule, asking providers who perform diagnostic digital breast tomosynthesis without performing accompanying 2D mammography to still code for both procedures.

As explained by the American College of Radiology’s (ACR’s) Advocacy in Action eNews, CMS inadvertently omitted the phrase “whether or not a 2D mammography is furnished” from the end of a passage in last year’s final rule. The full passage should have read:

Accordingly, we will wait to value the new diagnostic mammography tomosynthesis codes until we have received recommendations from the RUC for all mammography services. In the interim, we are assigning a PFS indicator of ‘‘I’’ to 77061 and 77062. Those furnishing diagnostic mammography using tomosynthesis will continue to report G0204 and G0206 as appropriate. In addition, we are creating a new code, G0279 (Diagnostic digital breast tomosynthesis, unilateral or bilateral (List separately in addition to G0204 or G0206)) as an add-on code that should be reported in addition to the relevant 2-D diagnostic mammography G-code to recognize the additional resources involved in furnishing diagnostic breast tomosynthesis whether or not a 2-D mammography is furnished.

The correction from CMS also points out that the code for diagnostic digital breast tomosynthesis, G0279, was originally printed as G-2079 in the above passage due to a typographical error.

CMS issued the correction following a conference call with representatives from the ACR, who expressed concern about advising providers to report a procedure code for a service that was not performed due to compliance issues. ACR advised practices to refer to the full CMS correction notice if an issue should arise.