September 29, 2021
Breast cancer is the second leading cause of death among women in the U.S., according to the Centers for Disease Control and Prevention (CDC). About 1 in 8 women will get breast cancer at some point in their life. October is Breast Cancer Awareness Month and a great time to talk with our members about the importance of regular screenings. We’ve created some resources that may help. Screening is the best way to find breast cancer early, when it’s easier to treat, and may help reduce the risk of death.
Closing Care Gaps
The U.S. Preventive Services Task Force recommends that women ages 50 to 74 be screened for breast cancer every two years. You may want to discuss with members the risks and benefits of starting mammogram screenings before age 50.
Breast cancer screening is also a Healthcare Effectiveness Data and Information Set (HEDIS®) measure from the National Committee for Quality Assurance (NCQA). The measure tracks women ages 50 to 74 who had at least one mammogram in the past two years. Blue Cross and Blue Shield of Illinois collects data from HEDIS measures to help assess and improve the quality of care our members receive.
See our preventive care guidelines on breast cancer screening.
Tips and Suggestions to Consider
- Talk with our members about breast cancer risk factors and regular screenings.
- Document screenings in the medical record. Indicate the specific date and result.
- Document medical and surgical history in the medical record, including dates.
- Use correct diagnosis and procedure codes. Submit claims and encounter data in a timely manner.
- For men who are at high risk , the American Cancer Society recommends discussing with them how to manage risks .
The above materials for informational purposes only and is not a substitute for the independent medical judgment of a physician or other health care provider nor is the information presented intended to replace or supersede any requirements set forth in your contract with BCBSIL. The information provided does not constitute coding or legal advice. Physicians and other health care providers are encouraged to use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment. The fact that a service or treatment is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider.
HEDIS is a registered trademark of NCQA. Use of this resource is subject to NCQA’s copyright,