Fee Navigator®

    Health Service Code X 27G

    Screening mammography for patients with the following conditions: implants, augmentation, mammoplasty, and when determined appropriate for screening by a radiologist and/or primary care physician, with the following conditions: post intervention (e.g. biopsy, excision, etc.)

    1. Benefits for HSCs 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. HSCs X27C and X27E must be referred initially. Subsequent referrals are not required. HSC X27D does not require a referral.
    4. HSCs X27C, X27D or X27E may not be claimed subsequent to HSC X27 within the same calendar year.
    5. Supplementary views, refer to HSC X27F.
    6. HSCs X27C, X27D, X27E, X27F (related to mammography work up), X27G, and TOMO modifier 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. HSCs X27C, X27D, X27E, and X27G may not be claimed in addition to HSCs X105 or X105A.
    8. Required data submitted to the Alberta Breast Cancer Screening Program or results communication cannot be claimed as 03.01S, 03.01T or 03.05JR.
    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:$165.76

    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$44.21

    Governing Rules:

    No Governing Rules.