Wiki Scrrening MM and Diag. MM

[GeriDe]

As of Jan. 1, 2015 MCR States you need a Modifier on the Screening when a screening and a diag MM are done on the same day. Does anyone know which modifier?

 

[JULIECLARK]

GG & GH modifiers

You can google these modifers and find the CMS website and guidelines.
These modifiers specific to mammograms are not new to 2015.


'"GG" is placed on the diagnostic mammogram when first a screening mammo is performed, then a diagnostic mammogram is then performed on the same day, two different sessions. This is for tracking purposes only.

"GH" is placed on the diagnostic mammo that has been converted from a screening to a dianostic at the same session. This means although a screening was the intent, there was a definitive finding, therefore the modifier is assigned to ensure payment is reimbursed as a screening. No copay for patient. This is a source of frequent customer requests for review.