# mammo w/ clip placement



## EikaMTGQueen (Nov 28, 2012)

If a patient has 2 sterotactic biopsies (1 @ 8:00 region & 1 @ 12:00 region) and the patient also has 2 specimens and 2 clip placements. after the clip placements 2 digital unilateral mammos were performed.

The question I have is can you code G0206 x 2 or just 1 unilateral mammo?

thanks:  confused:


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## crazygal (Nov 28, 2012)

*Diagnostic mammo w/biopsies*

You would only charge 1 unless one was done as preop and the other post. You would need times documented  and/or supportive documentation to support 2 separate times.


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## EikaMTGQueen (Nov 29, 2012)

The mammos are not pre-op, but they are both post-op to the clip placements. They also have both the 8:00 & 12:00 regions on the mammos. i just didnt think you can code 2 mammos.

Thanks


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## Lynda Wetter (Dec 6, 2012)

If a breast biopsy, needle localization wire, metallic localization clip, or other breast procedure is performed with radiologic guidance (e.g., 76942, 77012, 77021, 77031, 77032), the physician should not separately report a post procedure mammography code (e.g., 77051, 77052, 77055-77057, G0202-G0206) for the same patient encounter. The radiologic guidance codes include all imaging required to perform the procedure



DOES THIS HELP???


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## donnajrichmond (Dec 7, 2012)

AlwaysSunny said:


> If a breast biopsy, needle localization wire, metallic localization clip, or other breast procedure is performed with radiologic guidance (e.g., 76942, 77012, 77021, 77031, 77032), the physician should not separately report a post procedure mammography code (e.g., 77051, 77052, 77055-77057, G0202-G0206) for the same patient encounter. The radiologic guidance codes include all imaging required to perform the procedure
> 
> 
> 
> DOES THIS HELP???



AMA and ACR have said for several years now that it is appropriate to code for the post procedure mammogram in most cases as it is a separate exam.  There is even an MQSA approved assessment category for post procedure mammograms for marker placement (approved in 2003).
It is Medicare who will find every way they can to deny physicians / facilities appropriate payment, who now says this can't be coded.


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## Lynda Wetter (Dec 7, 2012)

donnajrichmond said:


> AMA and ACR have said for several years now that it is appropriate to code for the post procedure mammogram in most cases as it is a separate exam.  There is even an MQSA approved assessment category for post procedure mammograms for marker placement (approved in 2003).
> It is Medicare who will find every way they can to deny physicians / facilities appropriate payment, who now says this can't be coded.



I have not been able to find those particulars from the ACr but this statement was from the NCCI edits Chapter 9 page IX-10


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## tmlbwells (Dec 7, 2012)

My understanding is that if the report states that the patient was moved to the mammography suite, then a post procedure mammo can be coded.


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## donnajrichmond (Dec 7, 2012)

AlwaysSunny said:


> I have not been able to find those particulars from the ACr but this statement was from the NCCI edits Chapter 9 page IX-10



AMA / ACR Clinical Examples in Radiology, Fall 2010; Fall 2008; Fall 2005

Yes, that statement is new in the 2013 NCCI Policy Manual.  It has not been in the previous versions.


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## Lynda Wetter (Dec 11, 2012)

Donna, If you dont mind do you have a link for the clinical examples?
Thanks


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## clamberto@epiclp.com (Jan 13, 2015)

Check the 2014 National Correct Coding Initiative (NCCI) : 
   If a breast biopsy,needle localization wire,metallic localization clip,or other breast  procedure is performed with 'mammographic guidance' (eg,19281, 19282)....


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