Wiki billing screening mammogram

[MichaelGA]

The screening and diagnostic mammo LCD from FCSO instructs under the Coverage Guidance section that "...detection of a radiographic abnormality may prompt the interpreting radiologist to order additional views on the same day. When this is the case, the mammography is no longer considered to be a screening exam and should be reported as diagnostic."

But then in the section under ICD-10 Codes that support Medical Necessity,
"..when a screening mammo and a diag mammo are performed on the same date of service, for the same patient, append modifier-GG to the diag mammo code. Both the screening mammo and the diag mammo codes should be reported on the same claim."

Can anyone provide insight into that? It sounds contradicting.

I tried this in another group but didn't get a reply.

 

[mitchellde]

When the reason for the study is screening you always use the screening diagnosis code first listed, and any finding secondary, however for the procedure you drop the screening procedure code and us the diagnostic instead with a 33 modifier.

 

[jpg0925]

Need Help... Im very new to the Imaging practice. I started some billing for mammogram screening. Patient was a referral from a PCP. Does this mean that since we are doing the Mammography, do I need to append a modifier TC on my claim? Claim came back that it is part of something....... Our office just does the screening and interpretation for it.