October is Breast Cancer Awareness Month. According to the CDC, in 2016 (the latest year for which incidence data are available), 245,299 new cases of breast cancer in females were reported in the U.S., and 41,487 women have passed from breast cancer.

For every 100,000 women, 124 new cases of female breast cancer were reported and 20 women passed from cancer. Rhode Island’s incidence was higher, with a rate of 135.4 cases per 100,000 reported in 2016.

Currently, the average risk of a woman in the U.S. developing breast cancer sometime in her life is about 12 percent. This means there is a one in eight chance she will develop breast cancer. Fortunately, this also means there is a seven in eight chance she will never have the disease. 

According to the American Cancer Society, breast cancer is the second leading cause of cancer death in women (only lung cancer kills more women each year). The chance that a woman will die from breast cancer is about one in 38 (about 2.6 percent). Death rates from female breast cancer dropped 40 percent from 1989 to 2016. Since 2007, breast cancer death rates have been steady in women younger than 50, but have continued to decrease in older women.

These decreases are believed to be the result of finding breast cancer earlier through screening and increased awareness, as well as better treatments.

What is the measure?

The measure focuses on screening mammograms for women ages 50 to 74. Appropriate screenings include one or more mammograms on or between 31 de diciembre of the measurement year and 1 de octubre of the two years prior to the measurement year.

Codes:

CPT for mammograms: 77055, 77056, 77057, 77061, 77062, 77063, 77065, 77066, 77067

HCPCS for mammograms: G0202, G0204, G0206

Exclusions:

Bilateral mastectomy any time during the patient’s history. Any of the following meet criteria for bilateral mastectomy:

Bilateral mastectomy:  

ICD10: 85.42  85.46  85.44  85.48  0HTV0ZZ

Unilateral Mastectomy with a bilateral modifier:  

CPT: 19180  19200  19220  19240  19303  19304  19305  19306  19307

ICD10: 85.41  85.43  85.45  85.47

Modifier: 50

Two unilateral mastectomies with service dates 14 or more days apart:

CPT: 19180  19200  19240  19303  19304  19305  19306  19307

ICD10: 85.41  85.43  85.45  85.47

History of bilateral mastectomy:

ICD10: Z90.13