An Update on 3D Mammography

Several changes have occurred over the two years that Premier Health has offered 3D mammography. The Centers for Medicare and Medicaid Services (CMS) began covering this advanced imaging test more than a year ago. Commercial insurance companies followed suit. Now, many insurance companies, including Premier Health Plan, cover charges for 3D mammography.

Premier Health opted not to charge a technical fee for the exam for the past two years to make 3D mammography accessible to as many women as possible. Now that many insurance companies are covering this test, Premier Health is implementing a $60 technical fee for all 3D screening mammograms (a technical fee was previously charged for diagnostic mammograms). This new charge, which is covered by insurance, went into effect on December 1.

Women will still have a choice regarding whether to have a 3D or traditional 2D mammogram. If they choose 3D mammography, they are encouraged to first check their insurance plan for coverage.

The following questions and answers about 3D mammography are also available at premierhealth.com/3Dmammo:

What is 3D Mammography?
A 3-dimensional (3D) mammogram (also called tomosynthesis) is an advanced form of mammography that takes multiple images of the breast from several angles to form a 3D image. Viewing multiple images helps the radiologist better visualize fine details within the breast tissue, giving him or her a better opportunity to detect breast cancer at its earliest stage.

All Premier Health mammography locations offer Genius™ 3D MAMMOGRAPHY™.

What should I expect during a 3D mammogram?
There is very little difference between having a 3D mammogram and a 2D mammogram. Both use the same amount of breast compression, and both require you to hold your breath for a short period of time. The 3D mammogram may take a few extra seconds to complete, and the machine moves over the breast during the exam.

Is there more radiation with a 3D mammogram?
While there is an increase in radiation dose with 3D mammography as compared to traditional, 2D mammography, the radiation dose from 3D mammography is still below the limit under the Mammography Quality Standards Act set forth by the Food and Drug Administration.

What are the benefits of 3D mammography?
Research shows Genius™ 3D MAMMOGRAPHY™ can increase the detection of breast cancer by allowing the radiologist to better see the different structures as well as the location, size, and shape of any abnormal tissue.

Studies also show a reduction in “call backs” for additional images. When a radiologist sees an area in traditional mammography that is questionable, the patient is asked to return for additional imaging. With Genius™ 3D MAMMOGRAPHY™, the physician can see the breast tissue in smaller, thinner sections, reducing the need for call backs.

Who can have a 3D mammogram?
3D mammography is approved for all women undergoing either a screening or a diagnostic mammogram. Please note there are a few physical conditions that prevent us from using the 3D technology and that will be determined by the technologist upon discussion with you.

Where can I schedule my 3D mammogram?
All Premier Health mammography locations offer Genius™ 3D MAMMOGRAPHY™.

You can request Genius™ 3D MAMMOGRAPHY™ when you schedule your mammogram. Call central scheduling toll free at (855) 887-7364 to schedule your mammogram.

Is there any additional cost for 3D mammography, and will my insurance cover the additional charge?
The amount you owe depends on the benefits of your insurance plan. Please consult with your insurance company to clarify the coverage provided by your specific policy prior to having your next screening mammogram (CPT code 77063) or diagnostic mammogram (CPT code 77062) so you can make an informed decision at the time of your exam. Our mammography technologists will offer you a choice at the time of your exam.

At this point, whether you receive a 3D screening mammogram or a 3D diagnostic mammogram, you will receive two bills – one from the hospital and one from the radiologists who read your mammogram.

Updated Screening Mammogram Algorithm

We have heard some confusion regarding the best practice for breast screening, especially when dense breast tissue is found. To help reduce confusion and determine when an annual mammogram should be supplemented with a screening breast MRI, screening breast ultrasound, or a referral to a high risk breast center, the medical imaging team created an updated breast screening algorithm.

This algorithm is available for viewing or download from any Premier Health physician portal. The algorithm can be found under the “Refer a Patient” tab on the Clinical Algorithm page.

Back to the December 2017 issue of Premier Pulse