AMA Clinical Examples in Radiology - 2009 Issue 1 (Winter)
Mammography
Mammography Reason for Exam Annual screening exam. Patient asymptomatic. Examination Bilateral Digital Screening Mammogram. Examination G0202 Comparison is made with studies from 2004 and 2005. The dense nodular parenchymal pattern of both breasts demonstrates long-term stability, without suspicious developing density or mass lesion. There are scattered calcifications in both breasts that do not appear to have undergone significant or suspicious interval change. Recommendation is for continued annual screening mammography. The mammograms were also examined with computer-aided detection software. The American Cancer Society and the American College of Radiology recommend yearly screening mammograms beginning at age 40. Conclusion 3342F Benign...
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Article Overview
This article covers a screening mammography example and broader reporting guidance for mammography-related coding and quality reporting. It is useful for radiology coders, compliance staff, and practices that need to understand how mammography findings, computerized detection, and BI-RADS-linked reporting are handled across CPT, HCPCS Level II, ICD-9-CM, and CPT Category II references.
Why This Topic Matters
Mammography reporting often involves more than one code set and may be affected by payer policy, quality reporting programs, and standardized imaging assessment categories. Understanding the scope of the article helps users identify whether it addresses their billing, documentation, or reporting workflow.
Article Sections
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Reason for Exam and Examination
Introduces the screening context and describes the type of breast imaging performed. Also presents the example documentation used to frame the coding discussion.
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Conclusion
Summarizes the imaging assessment and the general recommendation associated with the example study. Connects the findings to standardized breast imaging reporting.
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How to Code
Discusses the coding framework for the example, including primary procedure reporting and associated quality-reporting references. Also addresses related screening mammography coding considerations.
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Discussion
Provides broader context on payer variability, digital mammography reporting, computer-aided detection, and performance measure reporting. Includes references to mammography assessment categories and related reporting programs.
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Coding Tips
Offers general coding guidance on add-on reporting and the relationship between screening and diagnostic mammography references. Notes administrative and compliance considerations tied to the example.
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PQRI Tips
Addresses performance reporting program guidance and the impact of modifier use on measure reporting. Focuses on quality-reporting administration rather than clinical interpretation.
What You Will Learn
- How the article frames screening mammography documentation for coding review
- Which mammography-related code sets are referenced in the discussion
- How BI-RADS-linked performance reporting is presented at a high level
- What general topics are covered regarding digital imaging, CAD, and payer variation
- Which quality reporting considerations are mentioned for mammography claims
Who Should Read This
- Radiology coders
- Professional billers
- Compliance staff
- Mammography facility staff
- Quality reporting specialists
- Revenue cycle professionals
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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