Mammography remains one of the most critical areas of radiology practice, and one that is facing changes in reporting requirements and reimbursement policy. Even with additional mammography reporting requirements placed on radiology practices, the reimbursement value of mammography services has not changed to reflect the extra work. However, changes to the screening policy could provide increased mammography volume.
New Reporting Requirements
In March 2023, the FDA issued a Final Rule that went into effect on September 10, 2024, imposing certain specific reporting requirements for mammography results, along with some other quality control measures.
The new reporting requirements that are incorporated into the Mammography Quality Standards Act (MQSA) include:
- The addition of three new assessment categories in order to more precisely classify findings;
- A specific timeframe for reporting results when the findings are “Suspicious” or “Highly Suggestive of Malignancy”; and
- A requirement to include an assessment of breast density. Specifically,
- Changing the wording to be “dense” or “not dense” rather than the high or low-density phrasing in current use.
- The summary report provided to patients must include specific statements for dense or non-dense findings.
- The report provided to the patient's healthcare provider must include an overall assessment of breast density using one of four specific categories.
Breast density assessment is important not only for the patient's health but it also has reimbursement implications for radiologists. Breast density can often obscure lesions on conventional x-ray mammography, and so other screening modalities such as MRI or ultrasound are often recommended for follow-up. Patients with dense breasts might also require more frequent screening due to their increased risk.