Please be aware of new information recently provided to BreastCare providers regarding testing, covered procedures and codes.
New: Human Papilloma Virus (HPV) testing, Chlamydia, Gonorrhea, VDRL, and urinalysis are not reimbursable services. HPV testing for ASCUS Pap smears may be added in 2007. CBC is covered only preoperatively and during chemotherapy. The provider may not provide these or any other non-covered services without full disclosure to the patient that the services will not be paid by BreastCare. The patient must be informed that she will be responsible for payment of non-covered services. Only BreastCare providers that have signed a Public Health Service Agreement with the program may perform reimbursable services.
New: 88175 and 88142 (thin prep) are covered by BreastCare.
New: 76095 (stereotactic localization for breast biopsy, each lesion, radiological supervision and interpretation) is not reimbursable in the presence of a palpable breast mass.
New: Breast and Cervical Cancer, 622.1 (CIN II), and 233.1 (CIN III) are covered diagnoses for Medicaid Category 07. Refer patients with any of these diagnoses to 1-877-670-2273 for eligibility determination.
BreastCare can provide posters, brochures and other collateral materials to help you or your organization promote BreastCare awareness. For information on how to obtain these materials, call 1-877-670-CARE (2273).
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