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North Carolina Breast and Cervical Cancer Control Program <br /> 2016-2017 Services Fee Schedule(1) <br /> Global and Split Fees <br /> Both global and split fees apply to the breast procedures listed on page 1 of this fee schedule. The method <br /> and direction of payment will determine their usage for your facility. The following are the codes and <br /> definitions that apply: <br /> G=Global;the all-inclusive fee for performing and interpreting the service. <br /> TC=Technical Component;the fee for performing the service. <br /> 26=Professional Component;the fee for interpreting the service. <br /> Notes: <br /> (1) <br /> NC BCCCP covers only the physician's fee. Any facility charges associated with these CPT codes are not covered <br /> (2) <br /> All consultations should be billed through the standard"new patient"office visit CPT codes:99201-99205. Consultations billed as <br /> 99204 or 99205 must meet the criteria for these codes,and must be pre-authorized. Codes 99204 and 99205 are not appropriate for <br /> screening visits.Up to two consultation visits may be provided per screening cycle,if indicated. <br /> (3) <br /> HPV DNA testing is a reimbursable procedure if used for screening in conjunction with Pap testing or for follow-up of an abnormal <br /> It is not reimbursable as a primary screening test for women of all ages or as an adjunctive screening test to the Pap for women under <br /> Providers should specify the high-risk HPV DNA panel only. Reimbursement of screening for low-risk HPV types is not permitted. <br /> The CDC will allow for reimbursement of Cervista HPV HR at the same rate as the Digene Hybrid-Capture 2 HPV DNA Assay. <br /> CDC funds may be used for reimbursement of HPV genotyping <br /> (4) <br /> Up to three cervical biopsies,including ECC(endocervical currettage),per colposcopy will be covered by the BCCCP when the <br /> appropriate algorithm is followed. Each specimen container is counted as one biopsy. Under no circumstances are endometrial <br /> or vaginal biopsies covered by the BCCCP. <br /> (5) <br /> Codes 19081-19084 are to be used for breast biopsies that include image guidance,placement of localization device,and imaging of <br /> specimen.These codes should not be used in conjunction with 19280-19286. <br /> (6) <br /> Codes 19281-19286 are for image guidance placement of localization device without image-guided biopsy.These codes should not be <br /> used in conjunction with 19081-19084. <br />