AFFORDABLE HEALTHCARE MAMMOGRAMS: know your code!

August 1, 2012

the new affordable health care regulations go into place this week.  i wanted to understand how they would affect my benefits – especially concerning mammograms since, as you might guess, i finally have no need for contraceptive nor gestational diabetes screening.  i found out that mammograms are covered and no longer limited to one per year but ‘as many as deemed necessary.’  but here’s the rub – and why you, the patient/consumer must be on your administrative guard:  it all depends on THE CODE!  so insist, talk and review with your doctor and with the administrative assistant who has your code-destiny at their fingertips. 

if it’s coded as PREVENTATIVE:  COVERED AND COVERED AND COVERED (not that anyone wants multiple mammograms in one year – smush…owe).  for my fellow survivors: i understand that you are entitled to COVERED-PREVENTATIVE MAMMOGRAMS if you have been 5 years post-diagnosis and with no recurrence/evidence of disease.  

if it’s coded as DIAGNOSTIC:  you are still on the hook for your CO-PAY.

Please check and recheck but here’s what I’ve been told:

SCREENING/PREVENTATIVE (COVERED) MAMMOGRAM CODES (2):  G0202 AND 77052

 DIAGNOSTIC BILATERAL MAMMOGRAM (NOT FULLY COVERED): G0204 AND 77051

we’re not talking pennies out of our pockets so KNOW BEFORE YOU GO. GET YOUR MAMMOGRAM AND BE HEALTHY – and save your co-pay for your next stress-reducing vacation!   

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you should be FURIOUS too

November 17, 2009

livid.  beside myself.  the new mammogram ‘guidelines’ recommendation is an abomination and must have been lobbied solely by the insurance companies…because that’s about who it benefits.  i’m posting a link but i could have written the same post – i would have been dead by now also without proper screening.  to add the most base insult to injury, the ‘guidelines’ tell women to stop doing self-exams.  who the fuck is on that committee?  wealthy men who own a lot of insurance company stock?  i rarely wish people ill but this mean-spirited change makes me wish that they ‘learn’ what it means to to be misdirected about monitoring their own health issues.  really, they should rot.  while i’m still fuming, this blog post below speaks eloquently to the subject.  you should be furious too. 

http://www.huffingtonpost.com/kathleen-reardon/id-be-dead-by-now—-the_b_360538.html


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