AHA Coding Clinic® for HCPCS - 2010 Issue 4; ASK the EDITOR

Mammography to verify clip placement

We are seeking guidance regarding the appropriate reporting of CPT code G0206, Diagnostic mammography, producing direct digital image, unilateral, all views, following an ultrasound guided breast biopsy to verify clip placement. Previous guidance from our fiscal intermediary stated that this was considered integral to the procedure; however this is contrary to the guidance provided in Clinical Examples in Radiology and the ACR Radiology Coding Source. Both state that if the procedure is performed with a different modality, i.e., ultrasound guided breast biopsy with clip placement, that the post procedure mammography can be reported separately. Our desire is to be compliant in reporting this procedure appropriately. Can you clarify this issue for us? ...

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