AHA Coding Clinic® for ICD-9 - 2006 Issue 2; Ask the Editor
Screening Mammography and Fibrocystic Disease
The physicians at our facilities order routine screening mammographies for patients with known fibrocystic disease of the breasts. Per Coding Clinic Second Quarter 2003, page 3, “screening is the testing for disease or disease precursors in seemingly well individuals so that early detection and treatment can be provided for those who test positive for the disease. When a diagnostic test is ordered in the absence of signs, symptoms, or other evidence of illness or injury (e.g., screening), the principal or first-listed diagnosis should be the reason for the test.†Based on this guideline, it seems that code V76.12 would not be used since fibrocystic breast disease is documented. What should be the first-listed code for a screening mammography on patients with fibrocystic disease of the breast? ...
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Article Overview
This article addresses a common coding question involving screening mammography in the setting of documented fibrocystic breast disease. It explains the relevance of coding guidance from Coding Clinic and focuses on how the principal diagnosis is determined for a screening test when a related breast condition is present. The piece is intended for coders, billing staff, and compliance professionals working with breast imaging and diagnosis coding.
Why This Topic Matters
Correctly identifying the first-listed diagnosis for screening mammography affects claim accuracy and consistent application of diagnosis coding guidance in breast imaging cases.
What You Will Learn
- How screening mammography is discussed in the context of documented fibrocystic breast disease.
- How Coding Clinic guidance is used to frame the question of first-listed diagnosis for a screening test.
- What kinds of coding considerations arise when a screening service is ordered for patients with an existing breast condition.
- How the article frames the issue for diagnosis selection in mammography claims.
Who Should Read This
- Medical coders
- Billing specialists
- Compliance staff
- Revenue cycle professionals
- Radiology coding staff
Codes Discussed
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