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COVID-19

Breast Cancer Screening (BCS-E)

HEDIS Measure

Breast Cancer Screening (BCS-E)

Line of business: Commercial Medicaid Medicare

Data Collection Method:

Administrative (Claims)
Supplemental Data Submission

  • Standard - Electronic Clinical Data System (ECDS) Layout
  • Non-Standard - Medical Record

Measure Description

The percentage of women 50–74 years of age who had a mammogram to screen for breast cancer.

Numerator Compliance

One or more mammograms any time on or between October 1 two years prior to the measurement year and December 31 of the measurement year.

Best Practices

  • Educate members about the importance of early detection and encourage screening
  • Engage patients to discuss their fears about mammograms and let women know that the test is less uncomfortable and uses less radiation than it did in the past
  • Establish a standing order to obtain annual mammogram for eligible population
  • Document the month and year of most recent mammogram and/or mastectomy status, in the medical record

Quality Value Set Directory Coding Tips

Mammography

CPT

  • 77061
  • 77062
  • 77063
  • 77065
  • 77066
  • 77067

LOINC

  • 24604-1
  • 24605-8
  • 24606-6
  • 24610-8
  • 26175-0
  • 26176-8
  • 26177-6
  • 26287-3
  • 26289-9
  • 26291-5
  • 26346-7
  • 26347-5
  • 26348-3
  • 26349-1
  • 26350-9
  • 26351-7
  • 36319-2
  • 36625-2
  • 36626-0
  • 36627-8
  • 36642-7
  • 36962-9
  • 37005-6
  • 37006-4
  • 37016-3
  • 37017-1
  • 37028-8
  • 37029-6
  • 37030-4
  • 37037-9
  • 37038-7
  • 37052-8
  • 37053-6
  • 37539-4
  • 37542-8
  • 37543-6
  • 37551-9
  • 37552-7
  • 37553-5
  • 37554-3
  • 37768-9
  • 37769-7
  • 37770-5
  • 37771-3
  • 37772-1
  • 37773-9
  • 37774-7
  • 37775-4
  • 38070-9
  • 38071-7
  • 38072-5
  • 38090-7
  • 38091-5
  • 38807-4
  • 38820-7
  • 38854-6
  • 38855-3
  • 39150-8
  • 39152-4
  • 39153-2
  • 39154-0
  • 42168-5
  • 42169-3
  • 42174-3
  • 42415-0
  • 42416-8
  • 46335-6
  • 46336-4
  • 46337-2
  • 46338-0
  • 46339-8
  • 46350-5
  • 46351-3
  • 46354-7
  • 46355-4
  • 46356-2
  • 46380-2
  • 48475-8
  • 48492-3
  • 69150-1
  • 69251-7
  • 69259-0
  • 72137-3
  • 72138-1
  • 72139-9
  • 72140-7
  • 72141-5
  • 72142-3
  • 86462-9
  • 86463-7
  • 91517-3
  • 91518-1
  • 91519-9
  • 91520-7
  • 91521-5
  • 91522-3

SNOMED CT US Edition

  • 12389009
  • 24623002
  • 43204002
  • 71651007
  • 241055006
  • 241057003
  • 241058008
  • 258172002
  • 439324009
  • 450566007
  • 709657006
  • 723778004
  • 723779007
  • 723780005
  • 726551006
  • 833310007
  • 866234000
  • 866235004
  • 866236003
  • 866237007
  • 384151000119104
  • 392521000119107
  • 392531000119105
  • 566571000119105
  • 572701000119102