Question: Our radiologist recently performed a diagnostic mammogram on an elderly Medicare patient. At the end of the appointment, she wanted to see the doctor to discuss the results. Our radiologist spent about 20 minutes with the patient, talking not only about the mammogram but also about breast disease and the risk of cancer. May we bill an E/M service in addition to the bilateral mammography code?
Arizona Subscriber
Answer: No, that would be inappropriate. The service provided is included in the mammogram (76090, mammography; unilateral, or 76091 ... bilateral).
HCFA says that the relative value units (RVUs) for mammography depend on a number of components:
review of previous mammograms
discussion of the test with the patient
examination of the breasts and the patient
instruction of the technician regarding views
interpretation of the studies
determination if additional studies are indicated
discussion of the findings and recommendations with the patient
dictation of the report
follow-up notification of the patient or patient's physician.