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Blue Cross Blue Shield of Rhode IslandCommercial · Administrative · Physician · RI · Radiology, OB-GYN, Family Medicine +1 moreMedium impact

HEDIS Measure: Breast Cancer Screening (BCS)

Act
immediately
Effective date
Oct 1, 2019
Identified
Jun 20, 2026

Summary

BCBS Rhode Island has issued updated guidance on HEDIS Breast Cancer Screening measures for women ages 50-74, specifying acceptable mammography CPT and HCPCS codes and exclusion criteria for bilateral mastectomy patients. This appears to be quality reporting guidance rather than a billing policy change.

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What to do

immediately · 3 steps
01Review current mammography billing practices to ensure use of approved CPT codes (77055-77067) and HCPCS codes (G0202, G0204, G0206) for women ages 50-74.
02Verify billing system correctly excludes patients with bilateral mastectomy history (ICD-10 Z90.13) from breast cancer screening quality measures.
03Quality reporting team should update HEDIS measure tracking systems.

Codes mentioned

770557705677057770617706277063770657706677067G0202G0204G0206191801920019220192401930319304193051930619307Z90.13

Original notice

HEDIS Measure: Breast Cancer Screening (BCS)
bcbsri.com · Always check the source before changing claims.
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Related changes

See all Blue Cross Blue Shield of Rhode Island changes →
August 2017MediumNo effective date · Provider UpdateJune 2017MediumNo effective date · Provider UpdateHints for HEDIS® (and more)MediumEffective Sep 1, 2020 · PhysicianBrowse every Blue Cross Blue Shield of Rhode Island change in the policy list

Related policy hubs

Blue Cross Blue Shield of Rhode Island policiesRI policy changesRadiologyOB-GYNFamily MedicineInternal MedicineCode 77055Code 77056Code 77057Code 77061Code 77062Code 77063Code 77065Code 77066Code 77067Code G0202Code G0204Code G0206Code 19180Code 19200Code 19220Code 19240Code 19303Code 19304Code 19305Code 19306Code 19307Code Z90.13

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