Radiology Coding Alert

Reader Question:

Use Provider Discretion for Switch From Diagnostic to Screening Mammogram

Question: What are the guidelines for reverting back to a screening mammogram for a patient with a history of breast cancer?

Michigan Subscriber

Answer: Following a mastectomy or lumpectomy to remove malignant tissue from the breast, a provider may opt to eventually revert back from diagnostic mammograms to screening mammograms for follow-up preventive imaging. As the American College of Radiology (ACR) elaborates on in their FAQ section, there are no clear-cut rules (for Medicare or otherwise) on a specific timeframe that a provider may opt for to transition the patient back to screening mammograms. Rather, this decision is left up to the attending physician’s discretion so long as they have the patient’s consent.