Wiki US and Mammo Imaging Guidance for Wire Placement

[jtuominen]

Hi there--

Im new to breast procedures and have a question on imaging guidance of wire/marking clip placements.
On an ultrasound guided breast wire localization, are you allowed to bill both 76942 (for US guided needle placement) and 77032 if the provider orders a mammographic confirmation of the wire/marking clip location?

There is a CCI edit between these two codes and I while I know that there are hierarchy rules with other imaging modalites (MRI trumps CT, CT trumps US, and US trumps Fluoro) I'm wondering if there are some similar bundling rules with US and mammo.

Thank you very much in advance.

 

[tmlbwells]

I think if there is a mammographic confirmation film it would be 77055 or G0206 depending on whether it's digital or not.

 

[jtuominen]

I should clarify:

A patient presents for wire localization prior to a lumpectomy.
The patient came in for biopsy and clip placement at a previous visit.

The wire localization is performed under ultrasound guidance. After the wire is placed, a "post wire placement" mammogram is performed to confirm wire location.

Is this post wire placement mammogram billable?
If so, is it billable with 77032, or 77055?

I know that the ACR has indicated you can bill 77055 for clip placement confirmation post biopsy, but in this case, no biopsy is being performed and no clip is being placed, all that has occured on a previous visit.

Help!