UnitedHealthcare clarifies breast screening coverage

UnitedHealthcare has issued a clarification of its breast screening and imaging coverage policies, according to an update published March 3 by the insurance giant.

The insurer is removing coverage rationale for digital mammography, breast ultrasound, and computer-aided detection (CAD) for mammography: These imaging procedures are proven and therefore are not subject to a coverage review process, according to the company.

However, UnitedHealthcare stated that CAD is unproven as an aid for radiologists to interpret contrast-enhanced MRI of the breast and as an aid for radiologists to detect breast cancer with ultrasound. Therefore, these procedures will continue to be subject to a coverage review, UnitedHealthcare said.

The insurer communicated a summary of changes made to the medical policy for breast imaging for screening and diagnosing cancer in its November 2010 bulletin. The updated medical policy was effective January 1, 2011.