AMA Clinical Examples in Radiology - 2018 Issue 2 (Spring)
QUESTIONS AND ANSWERS
QUESTIONS AND ANSWERS Question Answer What modifier(s) should be used when screening and diagnostic mammograms are performed on the same patient on the same day of service? When screening and diagnostic mammograms are performed on the same patient on the same day of service, it is appropriate to report modifier GG, Performance and payment of a screening mammography and diagnostic mammography on same patient, same day, with the Current Procedural Terminology (CPT ® ) diagnostic study code 77065 , Diagnostic mammography, including computer-aided detection (CAD) when performed; unilateral, or 77066 , Diagnostic mammography, including computer-aided detection (CAD) when performed; bilateral. Modifier...
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Article Overview
This article addresses multiple radiology coding questions drawn from Clinical Examples in Radiology and related coding guidance. It focuses on how different imaging services are characterized at a high level, when separate reporting may be relevant, and where payer or Medicare policy considerations may come into play. The content is aimed at coders, radiology practices, and billing staff who need to compare common imaging scenarios and understand the coding resources referenced by the article.
Why This Topic Matters
Radiology coding often depends on distinguishing similar imaging services and understanding when more than one service is being reported. This article helps readers identify the relevant coding references and policy sources used in common outpatient imaging situations.
Article Sections
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Mammography on the Same Day
Discusses a same-day screening and diagnostic mammography scenario and references related CPT and HCPCS Level II guidance. It also notes payer considerations and a deleted Medicare-related code set reference.
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Complete Shoulder Ultrasound
Explains a question about the scope of a complete ultrasound examination for a shoulder joint. The section references a CPT ultrasound code and general documentation expectations for complete joint imaging.
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Computer-Aided Detection With Prostate MRI
Addresses whether computer-aided detection can be separately reported with prostate MRI studies. The section references CPT prostate MRI codes, an unlisted MRI procedure code, and payer processing considerations.
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Breast Ultrasound and Ultrasound-Guided Biopsy
Covers a breast imaging scenario involving diagnostic ultrasound and ultrasound-guided biopsy. The section references CPT breast ultrasound and biopsy coding, along with Medicare NCCI and separate-reporting considerations.
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Brachial Plexus Ultrasound
Reviews how ultrasound of the brachial plexus is categorized and referenced in the article. It also includes broader guidance on diagnostic ultrasound documentation and anatomic-site-based reporting.
What You Will Learn
- Which imaging topics are discussed in the Q&A article
- What coding references are cited for mammography-related scenarios
- How the article frames ultrasound coding by anatomic site
- What guidance is referenced for prostate MRI computer-aided detection
- Which policy sources are mentioned for Medicare and payer-related processing
- How the article approaches imaging and biopsy as separate clinical questions
Who Should Read This
- Radiology coders
- Coding auditors
- Billing staff
- Radiology practice administrators
- Physician documentation staff
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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