Summary
BCBS Rhode Island has released updated HEDIS quality improvement guidance focusing on breast cancer screening for women ages 50-74. This policy provides billing teams with specific CPT codes and documentation requirements to properly close care gaps and ensure compliant mammography claims processing.
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What to do
Action · 5 steps
01Billing team should review mammography claims to ensure proper documentation and coding.
02Use CPT Category II code 3014F for screening mammography when documented.
03Ensure all mammography screenings in medical records include specific date and result.
04Verify claims are submitted from the radiology facility where mammogram was performed.
05Update encounter forms to remind providers to document breast cancer screening discussions and annual history reviews.
Original notice
Hints for HEDIS® (and more)
bcbsri.com · Always check the source before changing claims.
Related changes
See all Blue Cross Blue Shield of Rhode Island changes →Hints for HEDIS® (and more)LowEffective Jan 1, 2019 · PhysicianHints for HEDIS® (and more)MediumEffective Feb 1, 2019 · PhysicianHints for HEDIS® (and more)MediumEffective Apr 1, 2019 · PhysicianHints for HEDIS® (and more)MediumNo effective date · PhysicianBrowse every Blue Cross Blue Shield of Rhode Island change in the policy list