3D Screening Mammograms

Screenings covered by Medicare and private insurance companies require that certain criteria be met. Wake Radiology recommends that patients check with their insurance carrier before scheduling their screenings to confirm coverage and payment. Exams that are not covered by payors are considered out-of-pocket procedures and are payable at the time of service. With the exception of screening mammography, all screening studies performed at Wake Radiology require a signed physician referral – regardless of insurance coverage.  

Breast Cancer Screenings: 3D Mammography

Breast cancer is the most common cancer in women worldwide. A mammogram can detect cancer early, when it is most treatable. Even though this is the case, nearly a third of American women currently do not get regular mammograms. Screening mammograms do not require a physician’s order. Wake Radiology simply requires that eligible patients have visited their physician within the past 18 months. Wake Radiology offers 3D mammography at all our breast imaging locations. Wake Radiology is the first outpatient practice in the Triangle to earn the American College of Radiology’s prestigious Breast Imaging Center of Excellence (BICOE) designation.

Annual Screening Mammograms For Women 40 and Older

The debate is now over on when to begin annual screening mammograms. A landmark study published by the American Cancer Society (ACS) in 2010 proves annual mammography screening of women in their 40s reduces the breast cancer death rate in women aged 40-49 by nearly 30 percent. Wake Radiology follows the American Cancer Society (ACS) and American College of Radiology (ACR) guidelines that recommend women have yearly mammograms from age 40-80. These guidelines are also supported by the Society of Breast Imaging (SBI), American Society of Breast Disease (ASBD) and American College of Obstetricians and Gynecologists. Women should have a mammogram every year as long as they do not have serious, chronic health problems such as congestive heart failure, end-stage renal disease, chronic obstructive pulmonary disease and moderate to severe dementia. Women with serious health problems or short life expectancies should discuss with their doctors whether to continue having mammograms. A baseline mammogram is a name used for a patient’s first screening mammogram. It is important because it is usually used as the basis for comparison in later tests. Wake Radiology also recommends that women continue self-exams each month to detect changes in their breasts. We also advise women to have a yearly clinical exam by their primary healthcare provider.

Insurance for screening mammograms for women 40 years and older

Screening mammograms are addressed by the Affordable Care Act (ACA) of 2010. The ACA health insurance reform legislation was passed by Congress and signed into law by President Obama on March 23, 2010. The ACA (also known as “Obamacare”) outlines the requirements for health plans to cover women’s preventive healthcare services, including screening mammography every 1-2 years for women 40 years and older, without cost sharing. Health plans are required to provide these preventive services only through an in-network provider. A patient’s health plan may allow her to receive these services from an out-of-network provider but may charge her a fee. Wake Radiology recommends that patients check with their insurance carrier before scheduling their annual mammogram to confirm coverage and payment.  Learn about Medicare and Medicaid

Early Screening Mammography for High-Risk Patients under 40 Years

Women who are at higher than average risk of breast cancer (for example, because of a family history of the disease or because they carry a known mutation in either the BRCA1 or the BRCA2 gene) should talk with their primary care physician or radiologist about whether to have mammograms before age 40, when to start and how often to have them. A common rule of thumb is to start annual diagnostic or screening mammograms seven to ten years prior to when the first-degree relative was diagnosed with pre-menopausal breast cancer or at age 30 for BRCA carriers (can be a combination of MRI/mammograms).

Insurance for screening mammograms for high-risk patients under 40 years

For women with private insurance, the cost of a baseline mammogram or annual mammograms for younger women who have a family history of breast cancer is typically covered without copayments or deductibles. Wake Radiology recommends that patients check with their insurance carrier before scheduling their baseline or annual mammogram to confirm coverage and payment. Learn about Medicare and Medicaid