Radiology Coding Alert

Question: When we do mammograms on full-figured women, we have to use twice the typical number of films. Can we get paid for the extra films in addition to the standard examination?

Vermont Subscriber

Answer: You seem to be asking whether you can code the additional films separately from the standard examination because large breasts cannot be examined within the field of view of a single standard-size film. The answer to this question is "no." You cannot separately code or bill the use of additional films to complete the standard views, whether the standard examination is screening or diagnostic. The number of views - not the number of films necessary to obtain these views -defines the examination

However, if the findings on a two-view screening mammogram necessitate additional views, you may separately code and bill these additional views. For Medicare, use a modifier to bill both the screening and diagnostic examination on the same date of service.

If the patient is called back for the diagnostic examination, code the screening examination on the first occasion and the diagnostic mammogram on the second date of service. In such a circumstance, no additional modifier is needed.