Breast Cancer Screening for Members Ages 40 to 74

June 27, 2024

In line with new U.S. Preventive Services Task Force recommendations, Blue Cross and Blue Shield of New Mexico recommends that breast cancer screening for our members begin at age 40 rather than 50. We are updating our Preventive Care Guidelines to reflect this change. Screening should continue every other year until age 74.

Routine screening for breast cancer is the best way to detect it early, according to the Centers for Disease Control and Prevention. Breast cancer is easier to treat when it’s caught earlier.

Tips to Close Gaps in Our Members’ Care

  • Talk with our members about breast cancer risk factors and the importance of regular screening for women. We’ve created resources that may help.
  • Breast cancer disproportionately affects Black women, according to the CDC. Talk with our members about the unique risks and barriers they may face, which can result in poorer outcomes than other women.
  • Document screenings in members’ electronic medical record. Indicate the specific date and result. This helps us track member progress on the quality measure Breast Cancer Screening from the National Committee for Quality Assurance.
  • Document medical and surgical history in the medical record, including dates. Use correct diagnosis and procedure codes. Submit claims and encounter data in a timely manner.
  • Offer telehealth services when available and appropriate for preventive care appointments.
  • Follow up with members if they miss their appointment and help them reschedule.
  • For members who need language assistance, let them know we offer help and information in their language at no cost. To speak to an interpreter, members may call the customer service number on their member ID card.
  • For members who have transportation barriers, let them know that we provide Medicaid members with free non-emergency transportation services, as well as mileage reimbursement.
  • See our Health Equity and Social Determinants of Health page for more information on health equity.

For men who are at high risk, the American Cancer Society recommends discussing with them how to manage risks.

 

The above material is for informational purposes only and is not a substitute for the independent medical judgment of a physician or other health care provider. Physicians and other health care providers are encouraged to use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment. The fact that a service or treatment is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider.