October is Breast Cancer Awareness Month

More women are getting breast cancer at younger ages, making screening more important than ever. The U.S. Preventive Services Task Force and the American Cancer Society advise all women at average risk to begin breast cancer screening at age 40. 

We encourage you to speak with your patients between the ages of 40 and 49 about when and how often they should get a mammogram.

The American Cancer Society* guidelines: 

• Women age 40 to 44 have the option to start screening with a mammogram every year. 
• Women age 45 to 54 should get mammograms every year. 
• Women age 55 and older can switch to a mammogram every other year or continue yearly mammograms. Screenings should continue as long as the patient is in good health and is expected to live at least 10 more years. 

Compliance and documentation tips 

It may also be helpful to have your staff chart-prep and flag patients that need an annual screening order placed during their visit. To help boost compliance, you can offer your patients a “standing order” for their annual screening mammogram, allowing them to complete the screening mammogram before their annual visit with you.

To help you make sure your records meet standards for the Healthcare Effectiveness Data and Information Set (HEDIS) measure, here are a few screening documentation tips to keep in mind:

• Specify “mammogram” and the date of service in the patient history. 
• If the exact date is unknown, it’s acceptable to document the month and year. A result is not required.
• Include documentation stating “mammogram completed” and the date of service.

Exclusions: 

• Documentation must indicate a bilateral mastectomy any time during the patient’s history through Dec. 31, 2026.
• Documentation in the patient records that a unilateral mastectomy on both the left and right side on the same or different dates of service through Dec. 31, 2026.
• Patients receiving hospice or palliative care any time during the measurement year.

To ensure accurate data capture, when ordering a screening, have your provider credentials co-located with the correct ICD-10 code(s).

Additional resources for providers and members can be found at cdc.gov and at komen.org. Also see recommendations on our member website for breast cancer screening and prevention resources.

*American Cancer Society