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August 2021

Remind your eligible patients to get regular mammograms

According to the American Cancer Society, 1 in 8 women in the United States will be diagnosed with invasive breast cancer in her lifetime. As a doctor, you can play an integral role in early detection by recommending regular screenings to your patients. Early detection through regular screenings is a key to better outcomes.

The Breast Cancer Screening, or BCS, HEDIS® measure (also a Medicare Star Ratings measure) assesses female patients ages 52 to 74 who had a mammogram to screen for breast cancer within the past two years. Specifically, we look at those who had a mammogram two years prior to a date that falls within the measurement year of Oct. 1 through Dec. 31.

The National Committee for Quality Assurance now allows patients to be excluded from the measure due to advanced illness and frailty. The committee acknowledges that measured services most likely wouldn’t benefit patients who are in declining health.

Read the Breast Cancer Screening tip sheet to learn more about this measure, including information to include in medical records, codes to include on patient claims to exclude patients who had a mastectomy and tips for talking with patients about this measure.  

HEDIS®, which stands for Healthcare Effectiveness Data Information Set, is a registered trademark of the National Committee for Quality Assurance.

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*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2020 American Medical Association. All rights reserved.