February 2021

3D Mammography Reimbursed in All States Beginning April 1

For dates of service beginning April 1, 2021, Harvard Pilgrim will provide reimbursement for digital breast tomosynthesis (3D mammography) for commercial members in all states in our service area.

The procedure provides a digital x-ray of the breast, and is proposed as an adjunct to 2D full-field digital mammography in screening for breast cancer or in helping to clarify unclear mammographic findings, particularly in young women, in whom mammography has lower sensitivity.

Claims for 3D mammography should be submitting by billing the appropriate mammography code:

  • 77061/77062 – Diagnostic digital breast tomosynthesis

3D mammography can also be reported using the following add-on codes:

  • +77063 – Screening digital breast tomosynthesis, bilateral
  • +G0279 – Diagnostic digital breast tomosynthesis, unilateral or bilateral

For more information, please refer to Harvard Pilgrim’s commercial Mammography Medical Policy and our updated Radiology and Non-Covered Services payment policies.

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