Radiology Coding Alert

Reader Question:

E/M With Mammography

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.