Radiology Coding Alert

Question: We are unclear about how to report tomosynthesis with a mammogram now that the CPT^® and HCPCS codes have been updated. Can you advise?

Codify Subscriber

Answer: Many coders have been as confused as you are following the 2017 updates to mammography codes, so CMS recently addressed this issue in its 2017 document, “Frequently Asked Questions for Mammography Services.”

The agency advises practices to report breast tomosynthesis using the applicable mammography code (G0202-G0206) along with the applicable add-on tomosynthesis code. The tomosynthesis codes are as follows:

• +77063 — Screening digital breast tomosynthesis, bilateral (List separately in addition to code for primary procedure)
• +G0279 — Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to G0204 or G0206).

“When breast tomosynthesis is furnished, practitioners should report one of G0202, G0204, or G0206 and one of G0279 or 77063,” CMS says. “For purposes of billing digital breast tomosynthesis, the appropriate, accompanying 2D image(s) may either be acquired or synthesized.”

Resource: For more from CMS on this issue, visit https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeeSched/Downloads/FAQ-Mammography-Services-Coding-Direct-Digital-Imaging.pdf.