May 11, 2015
Add-On HCPCS Code G0279 for Diagnostic Digital Breast Tomosynthesis
CMS announced that HCPCS code G0279 is to be used for diagnostic digital breast tomosynthesis, unilateral or bilateral. Being an add-on code, it must be submitted in addition to either HCPCS codes G0204 or G0206; it cannot be reported as a stand-alone service. Being unilateral or bilateral, HCPCS code G0279 has been assigned a bilateral indicator '2' in the Medicare Physician Fee Schedule Database (MPFSDB). A '2' indicator means special payment adjustment for bilateral does not apply. Because of this, bilateral modifiers (e.g., CPT modifier 50, HCPCS modifiers RT/LT) are not to be included and the units field should indicate a quantity of '1'.
For additional information on bilateral services and accessing the MPFSDB, please refer to this article.
Details specific to billing CPT modifier 50 are also available.