Radiology Coding Alert

Question: Our radiologist detected abnormalities in a screening mammogram and then did a bilateral diagnostic mammogram on the same day for an elderly patient. How can we report these two mammography services?

Idaho Subscriber

Answer: Clearly, your physician did two procedures, one screening and another diagnostic, on the same patient on the same date of service. You will report two mammography codes and append a modifier.

For the screening mammogram, you submit code G0202 (Screening mammography, producing direct digital image, bilateral, all views). For the diagnostic mammogram, you submit code G0204 (Diagnostic mammography, producing direct 2-d digital image, bilateral, all views) and append modifier GG (Performance and payment of a screening mammogram and diagnostic mammogram on the same patient, same day).

Confirm same date of service: The GG modifier allows you to unbundle G0202 and G0204, which you cannot typically report on the same date of service for the same patient. In the above scenario, if the provider performed the mammographies on different dates, then you wouldn’t need modifier GG on the claim.