Traditional MedicareCoverageHigh impact
Breast Imaging: Breast Echography (Sonography)/Breast MRI/Ductography
Medicare/CMS - LCD·Radiology·Local Coverage Determination
Effective date
Apr 1, 2026
We identified it
Jul 28, 2026
Summary
Unable to provide analysis. The policy document content was not included in the submission. While the metadata indicates this is a Wellpoint Federal Local Coverage Determination (L33585) for breast imaging procedures effective 4/1/2026, the actual policy text with specific billing codes, coverage criteria, and requirements is missing. Obtain the full policy document from the CMS URL provided to complete this analysis.
Action Required
URGENT - By 3/31/2026: Billing team must obtain and review the complete policy text from https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=33585&ver=34. This is a fresh policy update affecting breast imaging (echography, MRI, ductography) from Wellpoint Federal MAC (Parts A & B). Do not process claims under this LCD without reviewing the full policy document to identify specific covered procedures, billing codes, medical necessity criteria, and any prior authorization requirements. Failure to implement correct billing rules will result in claim denials.