Screening Mammography

Why This Topic Matters

Breast imaging claims can involve multiple studies on the same patient and same day, so accurate reporting depends on knowing which services were performed and what payer-specific guidance applies. This article helps readers recognize the coding and documentation context for screening, diagnostic follow-up, and ultrasound in a mammography workflow.

Article Sections

1. Clinical examples

   A set of breast imaging examples showing the progression from screening mammography to diagnostic follow-up and ultrasound. The cases illustrate the reporting context for a screening exam, a subsequent diagnostic exam, and an additional imaging study.

2. How to Code

   General coding guidance for the imaging services discussed in the examples, including payer and Medicare-related reporting considerations. This section also points to associated diagnosis coding and documentation issues.

3. Discussion

   Narrative explanation of the screening-to-diagnostic workflow and related reporting concepts. It addresses the role of assessment categories, same-day reporting considerations, and the use of breast ultrasound in follow-up evaluation.

4. Medicare Reporting Guidelines

   Medicare-oriented guidance for reporting concurrent screening and diagnostic mammography and the related tracking and payment context. The section also notes documentation and payer policy considerations.

5. ICD-9-CM Coding Tip

   Diagnosis coding guidance tied to screening mammography claims for a specific timeframe. The section focuses on historical screening-related diagnosis code use.

6. Reporting Criteria for Medicare Patients

   Criteria discussed for when additional testing may be performed in the Medicare setting after an abnormal diagnostic result. The section emphasizes documentation and notification requirements.