Remind Eligible Patients to Get Regular Mammograms

One in eight women in the United States has a lifetime risk of getting breast cancer, according to Susan G. Komen. The American Cancer Society states that it is a leading cause of cancer in women. Early detection is key to better outcomes for patients, and you play an integral role by recommending regular breast cancer screenings.

The Breast Cancer Screening (BCS) HEDIS^® measure assesses female patients ages 50 to 74 who had a mammogram to screen for breast cancer in the past two years.

The National Committee for Quality Assurance now allows patients to be excluded from the measure due to advanced illness and frailty. They acknowledge that measured services most likely would not benefit patients who are in declining health.

Read the BCS tip sheet to learn more about this measure, including information to include in medical records, codes to include on patient claims to exclude for mastectomy, and tips for how to engage with patients on completing their screenings.

Please reach out to ProviderClinicalConsulting@Premera.com if you have questions.

 Sources:

Understanding Breast Cancer Risk | Susan G. Komen^®

Breast Cancer Statistics | How Common Is Breast Cancer?

Healthcare Effectiveness Data Information Set. HEDIS^® is a registered trademark of the National Committee for Quality Assurance (NCQA).