US · guidance
CMS Pub. 100-04, ch. 18, § 20.5.1
A/B MACs (B) Claim Record for CWF
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.
History
(Rev. 3844, Issued: 08-18-17, Effective: 01-01-18, Implementation: 01-02-18)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
46009d50e3c0ab132dcdbfc2e4e6f0887d3c673318613cb9c1a620210d18ce43
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