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Radiology Coding Alert

You Be the Coder:

Code Screening Mammo With Cyst

Published on Wed Oct 13, 2010

Question: A patient presents to our office for a routine screening mammogram (not digital). Our radiologist sees a cyst and wants a breast ultrasound performed. How should we code the mammogram? Can we still call this a screening mammogram?Tennessee SubscriberAnswer: The mammogram is still a screening mammogram regardless of the findings. So you should report 77057 (Screening mammography, bilateral [2-view film study of each breast]), the appropriate V-code (V76.11, Screening mammogram for high-risk patient; or V76.12, Other screening mammogram) and the appropriate cyst ICD-9 code, based on the documentation.Watch for: Medicare Claims Processing Manual chapter 18, section 20.6.B, explains you may also assign a diagnostic code for additional films taken the same day. You don't mention additional films, but if you do perform them, you should report 77057, 77055-GG (Mammography; unilateral; Performance and payment of a screening mammogram and diagnostic mammogram on the same patient, same day), assuming the diagnostic [...]
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