Questions - 1068 l Posts - 2982
Questions - 1188 l Posts - 3129
Questions - 198 l Posts - 604
Questions - 355 l Posts - 991
Questions - 25 l Posts - 71
Questions - 272 l Posts - 756
Questions - 965 l Posts - 2648
Questions - 1103 l Posts - 2865
Questions - 2582 l Posts - 7048
Questions - 589 l Posts - 1633
Questions - 311 l Posts - 884
Questions - 567 l Posts - 1698
Questions - 2612 l Posts - 7277
Questions - 193 l Posts - 481
Questions - 744 l Posts - 1952
Questions - 87 l Posts - 204
Questions - 2853 l Posts - 7319
Questions - 663 l Posts - 1700
Questions - 283 l Posts - 787
Questions - 83 l Posts - 218
Questions - 569 l Posts - 1490
Questions - 602 l Posts - 1769
Questions - 194 l Posts - 508
Questions - 219 l Posts - 552
Questions - 382 l Posts - 1025
Questions - 247 l Posts - 658
Questions - 591 l Posts - 1655
Questions - 766 l Posts - 2065
Questions - 1184 l Posts - 3010
Hi,
The problem, however, seems to lie in the way the Centers for Medicare and Medicaid Services (CMS) has been handling payments for 77065. CPT® introduced 77065 mammography codes effective Jan. 1, 2017. However, the Medicare Physician Fee Schedule (PFS) assigned a status of "I" to these codes, "indicating that these codes are not payable under the PFS until Jan. 1, 2018".
In other words, Medicare was not paying for any 77065 services for the entire 2017 calendar year. Instead, CMS instructed providers to report code G0206 (Diagnostic mammography, including computer-aided detection (CAD) when performed; unilateral) rather than 77065 on claims with dates of service Jan. 1, 2017 through Dec. 31, 2017.
On February 2, 2018, CMS released Transmittal 3961, which contained "instructions to modify system edits to pay claims containing code 77065, 77066, or 77067".
So, CMS will be paying for 77065 moving forward, but you should check with your Medicare Administrative Contractor (MAC) to see if CMS will process claims with dates of service prior to Jan. 1, 2018, with that code or whether you need to re-submit with code G0206 in lieu of 77065.
Please confirm the date on your claim.
Thanks
Hi,
As per CPT guidelines, CPT 77065 can be billed only 1 time per day as its MUE value is 1. You will not get paid for second one.
Thanks