2017-388 Health - UNC Health Care System for BCCCP mammogram screenings

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North Carolina Breast and Cervical Cancer Control Program 2017 Services Fee Schedule(1) NOTES: (1) NC BCCCP covers only the physician's fee. Any facility charges associated with these CPT codes are not covered (2) Code 77063 should be listed as a separate code in addition to the code for the screening mammogram code,77057 or (3) Code G0279 should be listed as a separate code in addition to G0204 or G0206 for the primary mammogram. (4) Codes 19081-19084 are to be used for breast biopsies that include image guidance,placement of localization device,and imaging of specimen.These codes should not be used in conjunction with 19281-19286. (5) Codes 19281-19286 are for image guidance placement of localization device without image-guided biopsy.These codes should not be used in conjunction with 19081-19084. (6) HPV DNA testing is a reimbursable procedure if used for screening in conjunction with Pap testing or for follow-up of an abnormal Pap or surveillance per ASCCP guidelines. 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 30 years of age. Providers should specify the high-risk HPV DNA panel only.Reimbursement of screening for low-risk HPV types is not permitted. The CDC will allow for reimbursement of Cervista HPV HR at the same rate as the Digene Hybrid Capture 2 HPV DNA CDC funds may be used for reimbursement of HPV genotyping. (7) All consultations should be billed through the standard"new patient"office visit CPT codes:99201-99205. Consultations billed as 99204 or 99205 must meet the criteria for these codes,and must be pre-authorized. Codes 99204 and 99205 are not appropriate for NC BCCCP screening visits. N.C.Department of Health and Human Services,Division of Public Health, Page 5 Chronic Disease and Injury Section,Cancer Prevention and Control Branch 2/2017