Fee Navigator®

    Health Service Code X 27E

    Screening mammography (age 75 years and over)

    1. Benefits for X27C, X27D and X27E include patient education. A visit benefit may not be claimed in conjunction with these services by the radiologist performing the screening mammogram or by a different radiologist in conjunction with the same radiological examination.
    2. Only one Screen Test or fee-for-service benefit may be claimed every calendar year.
    3. X27C and X27E must be referred initially. Subsequent yearly referrals are not required. X27D does not require a referral.
    4. X27C, X27D or X27E may not be claimed subsequent to X27 within the same calendar year.
    5. Supplementary views, refer to X27F.
    6. X27C, X27D and X27E require submission of data to the Alberta Breast Cancer Screening Program through either the Alberta Society of Radiologists or the Alberta Health Services' Screening Programs.
    7. X27C, X27D or X27E may not be claimed in addition to HSCs X105 or X105A.
    Additional notes:
    • Listed under - DIAGNOSTIC RADIOLOGY:

      As stated in G.R. 11.1.1, claims for services in the Diagnostic Radiology section will not be payable unless the physician has been approved by the CPSA to provide those services.

    Category:T Test
    Base rate:$125.19

    AMA billing tips:

    • When tomography is used in addition to the mammography service the TOMO modifier may be claimed in addition. The modifier replaces the billing practice of claiming X105 in addition to the mammography codes.

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    XRAYTOMOYesIncrease By$44.10

    Governing Rules:

    • 11.3.3

      Benefits are intended for diagnostic or therapeutic purposes. Mass screening services with the exception of HSCs X27C, X27D, X27E and X27F are not to be claimed.