The American Cancer Society (ACS) recently released new recommendations for women at average risk for breast cancer. These recommendations more closely align ACS and U.S. Preventive Services Taskforce (USPSTF) guidelines and convey the overall movement towards less frequent breast screenings.
The Colorado Department of Public Health and Environment’s Women’s Wellness Connection (WWC) program continues to align its breast screening policies with USPSTF guidelines. WWC believes the ACS recommendations are evidence-based, concerned with public resources, but also concerned about the negative health effects or harms of overscreening (i.e. overdiagnosis and false positives), particularly in younger women.
The importance of assessing a woman’s individual risk for breast cancer is even more essential as screening mammography guidelines continue to evolve. CDPHE and WWC encourage all women to talk with their healthcare provider about their risk for breast cancer and screening options. If you know someone that is in need of breast cancer screening and meets the criteria below, they may qualify for WWC. Please call the WWC referral number 1-866-951-WELL (9355) to schedule an appointment.
- 40-64 years old
- uninsured or underinsured
- low-income
- lawfully present
Ford has partnered with Lyft, a peer-to-peer ridesharing program, on an initiative that will allow anyone in Lyft’s 60 US markets to request a free ride to and/or from breast cancer treatment. Patients that would like to request a ride can visit lyft.com/moregooddays and click “get a ride” or “give a ride." Please share this information with your local communities and help Ford reach its goal of 10,000 rides!
Question: Does WWC reimburse for 3D mammography (i.e. tomosynthesis)? What are the tomosynthesis CPT codes we should be aware of?
Currently, mammograms are one of the best methods for detecting breast cancer at an early stage. We also know that side effects from mammography screening can occur. This article from MedlinePlus, a website from the U.S. National Library of Medicine, discusses the rate of five psychosocial consequences that occur due to false-positive mammogram results. The article is based on a Swedish study published in Cancer Epidemiology, Biomarkers & Prevention (August 2015). WWC’s guidance includes having a detailed conversation with patients to discuss potential harms and benefits, before referring for screening mammography. This is particularly important in women 40-49 years of age.
Referring a client into WWC for diagnostics is a unique type of referral:
- A WWC diagnostic referral occurs when a client has screening procedures paid using non-WWC funds and is subsequently enrolled in WWC for coverage of her diagnostic work-up.
- When referring a client in for WWC diagnostics, select “Referred in for Diagnostic Evaluation” in the Current Pap Reason or Current Mammogram Reason field in the Medical History Section.
- The date of Mamm or Pap referral should match the date of the first WWC funded diagnostic procedure.
- Enter all screen procedures. Note that they must be non-WWC funded. If your organization is requesting reimbursement for screening procedures, change the Current Mam/Pap reason from “Referred in for Diagnostic Evaluation” to a more appropriate selection.
- After entering the screening procedures funded by a source other than WWC, enter the WWC-funded diagnostic procedures.
- Entering a Final Diagnosis is required for all clients referred into WWC for diagnostics.
