AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2015 Issue 1; Ask the Editor
Screening Mammogram with Finding of Dense Breasts
What is the correct ICD-10-CM diagnosis code assignment for an encounter for a screening mammogram, when the patient is found to have dense breasts? The ICD-10-CM Official Guidelines for Coding and Reporting, Section I, C, 21, c, 5, clarifies that a screening code is the first listed code if the reason for the visit is specifically the screening exam. If a condition is discovered during the screening then the code for the condition may be assigned as an additional diagnosis. Should code R92.2, Inconclusive mammogram, be assigned as an additional diagnosis when dense breasts are documented? ...
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Article Overview
This premium coding article explains how to approach ICD-10-CM diagnosis coding for a breast cancer screening mammogram when dense breasts are documented. It is aimed at coders, billers, and compliance staff who need to understand screening-exam sequencing, incidental finding handling, and how the ICD-10-CM Official Guidelines apply in this scenario.
Why This Topic Matters
Correct diagnosis coding for screening mammography affects claim accuracy and consistency with ICD-10-CM Official Guidelines. This topic matters for professionals who code preventive breast imaging and need to distinguish the primary screening reason from additional findings documentation.
What You Will Learn
- How ICD-10-CM screening-exam guidance applies to mammography encounters
- How documentation of dense breasts is discussed in the context of screening
- How incidental findings during screening are handled at a broad level
- How to interpret the article’s coding focus for breast imaging claims
Who Should Read This
- Medical coders
- Coding auditors
- Billing staff
- Compliance professionals
- Healthcare revenue cycle teams
Codes Discussed
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