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MIR-20007-1AB, January 2007
MLN Matters. . .Information for Medicare Providers
(Issued by the Centers for Medicare & Medicaid Services)
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New 2007 Current Procedural Terminology (CPT) Mammography Codes
Provider Types Affected
All physicians and providers who bill Medicare carriers, fiscal intermediaries (FI), or Part A/B Medicare Administrative Contractors (A/B MACs) for providing mammography services
Provider Action Needed
Impact to You
As part of the annual HCPCS update, CMS has assigned new 2007 Current Procedural Terminology (CPT) mammography codes for screening and diagnostic mammography services. Effective January 1, 2007, these codes (77051, 77052, 77055, 77056, and 77057) will replace the current CPT codes; however the CPT code descriptors for the services are unchanged.
What You Need to Know
Failure to submit the correct codes will cause your claims to be returned and not processed.
What You Need to Do
Make sure that your billing staffs are aware of the CPT code changes.
Background
CR 5327, from which this article was taken, announces the assignment of new CPT codes for screening and diagnostic mammography services.
As part of the annual HCPCS code update, CMS has assigned new 2007 CPT mammography codes for screening and diagnostic mammography services. Effective January 1, 2007, these codes (77051, 77052, 77055, 77056, and 77057) will replace the current CPT codes; however the CPT code descriptors for the services are unchanged.
The following table displays the new (and old) replacement codes and their description.
2007 Screening and Diagnostic Mammography CPT codes
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| New Code |
Old Code |
Description |
77051 |
76082 |
Computer aided detection (computer algorithm analysis of digital image data for lesion detection) with further physician review for interpretation, with or without digitization of film radiographic images, diagnostic mammography. (list separately in addition to code for primary procedure) |
77052 |
76083 |
Computer aided detection (computer algorithm analysis of digital image data for lesion detection) with further physician review for interpretation, with or without digitization of film radiographic images, screening mammography. (list separately in addition to code for primary procedure) |
77055 |
76090 |
Diagnostic mammography, unilateral |
77056 |
76091 |
Diagnostic mammography, bilateral |
77057 |
76092 |
Screening mammography, bilateral (two view film study of each breast) |
Be advised that carriers and FIs will return claims (with dates of service on or after January 1, 2007) that contain the old screening and diagnostic mammography codes. And also effective January 1, 2007, frequency standards for screening mammography will be applied to the new screening codes (77052 and 77057).
Additional Information
You can find more information about the new 2007 mammography CPT codes by going to CR5327, located at http://www.cms.hhs.gov/Transmittals/downloads/R1070CP.pdf  on the CMS Web site.
There, as an attachment to that CR, you will find revised Chapter 18 (Preventive and Screening Services), Section 20 (Mammography Services) of the Medicare Claims Processing Manual (100-04).
If you have any questions, please contact your carrier, FI, or A/B MAC at their toll-free number, which may be found at http://www.cms.hhs.gov/MLNProducts/downloads/CallCenterTollNumDirectory.zip. 
Disclaimer This article was prepared as a service to the public and is not intended to grant rights or impose obligations. This article may contain references or links to statutes, regulations, or other policy materials. The information provided is only intended to be a general summary. It is not intended to take the place of either the written law or regulations. We encourage readers to review the specific statutes, regulations and other interpretive materials for a full and accurate statement of their contents.
MLN Matters Number: MM5327
Pub. 100-4, Transmittal# R1070CP, CR# 5327
Related CR Release Date: September 29, 2006
Effective Date: January 1, 2007
Implementation Date: January 2, 2007
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