Breast cancer is the second most common cancer among women in the United States, trailing only behind some kinds of skin cancer. Deaths from breast cancer are higher than those for any other cancer, besides lung cancer.

Breast Cancer Awareness Month, which is marked in countries across the world each October, is an annual health campaign to increase awareness of the disease. Its purpose is to remind women to perform monthly breast self-exams and look for symptoms of breast cancer, including:

  • Any change in the size or the shape of the breast
  • Pain in any area of the breast
  • Nipple discharge other than breast milk (including blood)
  • A new lump in the breast or underarm

As of January 2020, there are more than 3.5 million women with a history of breast cancer in the U.S., including women currently being treated and those who have finished treatment. Black women are more likely to be diagnosed with aggressive subtypes of breast cancer and die from the disease at a higher rate than white women. Less than one percent of all breast cancers occur in men, but about 2,620 men are expected to be diagnosed with the disease in 2020.

CMS’ Proposed 2021 Medicare Payment System Changes

CMS released its annual proposal for changes to the Medicare payment system for 2021. In addition to proposed Medicare reimbursement adjustments to MPFS, there are proposed revisions to QPP for next year and beyond. As noted by Healthcare Administrative Partners, the comparison of proposed Medicare RVUs and Fee Schedule for 2021 to 2020 values is as follows:

For medical billers, it’s important to note that current CPT rules for office visits state that time can be used to select a code for a new or established patient the visit is dominated by counseling or care coordination. The rule will change for 2021, allowing time to be used for codes 99202–99215, even if counseling dominates the visit.

New Technologies for Detecting Breast Cancer

Researchers, scientists and other professionals around the world are committed to finding not only a cure for breast cancer but also treatments and technology that improve the health of patients diagnosed with the disease. Although not all of the technologies highlighted in this blog are utilized on a mainstream basis throughout the world, many of them have produced positive results for detecting and treating breast cancer.

Tomosynthesis (3D mammography)

An imaging test that creates a three-dimensional view of the breast tissue, digital breast tomosynthesis enables breast tissue to be viewed in individual segments. Sometimes used with ultrasound, many scientists believe it detects masses in dense tissue better than 2-D mammography technology. One of its advantages is that it lets physicians evaluate glandular tissue in greater detail.

Billing note: Breast tomosynthesis should be reported using the applicable mammography code (77065-77067) along with the applicable add-on tomosynthesis code (77063 or G0279).

Breast-shaped Mammogram Paddles

Many women complain of painful mammograms. These curved compression mammogram paddles are shaped like a woman’s breast and are used with a SmartCurve Breast Stabilization System with 3D imaging. However, they are not designed to be used on women with very small or large breasts or those with certain types of implants.

Abbreviated MRI

A study published earlier this year in theJournal of the American Medical Association (JAMA) reported that this new test, which utilizesfewer images than full MRI and reduces the length of a standard scan from 45 to 10 minutes, found far more cancers than 3D mammography in women at average risk who have dense breasts. Multiple clinical studies have shown that this MRI protocol would not affect sensitivity or specificity for breast MRI screening purposes. 

Artificial Intelligence (AI) Model for Mammography Images

Multiple researchers from around the world designed and trained an AI model on mammography images from approximately 29,000 women, and it was able to correctly identify cancers from the images with a similar degree of accuracy to expert radiologists. The researchers note, though, that further testing in larger populations is required to provide the technology’s efficacy.

Upright Affirm® Biopsy System
This system, developed by Hologic, enables patients to sit upright in a chair as a high-tech machine is centered over the breast to precisely calculate spot where the biopsy needle needs to be inserted. According to physicians from the University of Chicago Medicine, this technology cuts the test time from 30 minutes to about 15 and makes the biopsy procedure easier and more comfortable for patients.
Magtrace™ and Sentimag® Magnetic Localization System

Endomagnetics Ltd. received FDA approval to market this magnetic device system, which is used to guide lymph node biopsies in patients who are undergoing mastectomy for breast cancer. The system’s Magtrace particles, asolution made of iron nanoparticles coated with a carboxydextran shell, are injected into a patient’s breast tissue and absorbed into the lymph nodes. Using the Sentimag probe on the patients’ skin near the tumor site, a surgeon detects the magnetic particles located within the sentinel lymph node and removes the node to be tested for the presence of cancer cells.

The Centers for Disease Control and Prevention (CDC) recommends doing these things to lower your breast cancer risk:

  • Keep a healthy weight and exercise regularly.
  • Don’t drink alcohol, or limit the amount of alcohol you drink.
  • If you are taking hormone replacement therapy or birth control pills, ask your doctor about the risks.
  • Breastfeed your children, if possible.

At 4D Global we have a team of Radiology Billing Specialities that work on coding, charge entry, payment posting, and revenue cycle management.  Learn about the 4D Global team and the services we offer.

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