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April 2018
Timely information from Ladies First! 


The Ladies First website has a new home! We have finally joined the Health Department's website. The new website has all of the same resources as the old one, with a fresh look and feel!  


 


   
 
Heart Health Coverage on Hold

Starting July 1
 
There are some important changes coming to Ladies First membership services. One of our grants is coming to an end this June. This means that starting July 1st, Ladies First will not be able to cover the cost of heart health screenings and Lifestyle Programs, unless funding is renewed.
 
But don't worry, Ladies First isn't going anywhere! Ladies First will continue to cover the cost of breast and cervical cancer screenings, including Pap tests, mammograms and needed diagnostic tests. We will also provide support and guidance along the way.
 
Starting July 1, Ladies First will no longer cover: 
  • Annual heart screenings
  • Blood pressure measurements
  • Total cholesterol tests
  • Lipid profile tests
  • HA1c tests
  • Blood glucose tests
  • Weight Watchers
  • Tops (Take Off Pounds Sensibly)
  • Curves Complete
  • Self-Monitored Blood Pressure Program
  • Other local weight management and fitness programs

We realize these changes could impact your patients health goals. We hope to again offer these important services to our members and will be in touch once we know more about funding. In the meantime, we are committed to making this change as smooth as possible. Please call Ladies First at 800-508-2222 with questions and to find out if there are other lifestyle programs or services available to your patient's in your area.

Updates to Breast and Cervical Cancer

Screening Services
  • Women under the age of 40 who are determined to be high-risk for breast cancer may be screened through Ladies First even if they are not symptomatic.
     
  • The target goal for cervical cancer screening is 20% never screened. The term "rarely" screened (for more than 5 years) has been removed from the Ladies First goal.
Breast screening
According to the Centers for Disease Control, all women should undergo a risk assessment to determine if they are at high risk for breast cancer. Ladies First can pay for annual breast cancer screening among women who are considered at high-risk for breast cancer. "Women at high-risk" includes those who have a known genetic mutation such as BRCA 1 or 2, first - degree relatives with premenopausal breast cancer or known genetic mutations, a history of radiation treatment to the chest area before the age of 30 (typically for Hodgkin's Lymphoma),
and a lifetime risk of 20% or more for development of breast cancer based on risk assessment models that are largely dependent on family history. These women should be screened with both an annual mammogram, annual breast MRI and/or additional services as needed and approved by Ladies First.

Cervical screening
Women who are at high risk for cervical cancer need to be screened more frequently than average - risk women. This includes women with HIV infection, who have
had an organ transplant, who may be immunocompromised from another health condition or who had DES exposure in utero. In general women under the age of 30 should undergo annual Pap testing and women age 30 years and older should have co-testing every 3 years or annual Pap testing.


 

 

Fee Schedule

Released
 
The Ladies First 2018 Fee Schedule has been released! Mammogram codes G0202, G0204 and G0206 have been removed for 2018 but are still payable for 2017 dates of service. Ladies First will continue to pay for mammogram codes 77065, 77066 and 77067.

Don't see a diagnosis code on our list? Call the Ladies First billing specialist at
800-508-2222 for claim review and possible manual payment.