Medicare Claims Processing Manual (Pub. 100-04), Ch. 18 § 20.5.1

A/B MACs (B) Claim Record for CWF

Last amended: 2017Year: 2017Length: 159 wordsOfficial source
20.5.1 - A/B MACs (B) Claim Record for CWF (Rev. 3844, Issued: 08-18-17, Effective: 01-01-18, Implementation: 01-02-18) B3-4601.3.B A/B MACs (B) complete the type of service field in the CWF Part B claim record with a “B” if the patient is a high risk screening mammography patient or a “C” if she is a low risk screening mammography patient for services prior to January 1, 1998. For services on or after January 1, 1998, the type of service field on CWF must have a value of “1” for medical care (screening) or a “4” for diagnostic radiology (diagnostic). Fill in POS. Fill in deductible indicator field with a “1”; not subject to deductible if screening mammography. Submit the claim to the CWF host. Trailer 17 of the Part B Basic Reply record will give the date of the last screening mammography. The CWF edits for age and frequency for screening mammography. There are no frequency limitations on diagnostic tests.
Medicare Claims Processing Manual (Pub. 100-04), Ch. 18 § 20.5.1: A/B MACs (B) Claim Record for CWF | Justis AI