Entry DateJanuary 31, 2023
TopicRadiology
Member NameDiana Caruso
FacilityMorristown Medical Center
Question

I was wondering if you had a mammography person who may be able to help me with this question.
In NJ, we have a Dense Breast Law, which entitles patient’s with dense breasts to a Complete Ultrasound.
Medicare is monitoring the rates of screening Medicare patients who then go on to receive a Complete Breast Ultrasound.
They are compiling the number of screening mammograms then comparing them to the number of complete breast ultrasounds, considered as diagnostic ultrasounds as there is no “screening” ultrasound.
Thus, we are being told our call back rate of Complete Ultrasounds is too high…we are above the “norm” and we need to bring our numbers down for these ultrasounds.

Is there anyone that might have some information on this, or what other centers do if they have dense breast laws?

Expert Response: OK so I think this is a semantic issue. A screening us is not a "call back" from an incomplete mammogram. It is a separate study and should not be counted as such. The mammogram is either a biradc1 or 2 not a 0.
Not sure why your Medicare folks would consider it that way.