How to bill for mammography screenings

Why This Topic Matters

Mammography billing is affected by service type, imaging technology, modifier usage, diagnosis selection, and facility certification. Readers need this guidance to better understand how Medicare-related claim requirements are organized for screening and diagnostic breast imaging.

Article Sections

1. Screening mammography billing

   Overview of billing topics for screening mammography services, including Medicare-related code selection, add-on imaging review, and component billing considerations.

2. Coverage, diagnosis, and certification considerations

   Discussion of Medicare coverage timing, diagnosis code reporting, FDA certification requirements, and related claim documentation points for facilities that provide mammography services.

3. Diagnostic mammograms

   Coverage and billing context for diagnostic mammography services, including when diagnostic imaging is considered and how it relates to claim submission requirements.

4. Coding and modifier guidance for diagnostic mammography

   General billing guidance for diagnostic mammography claims, including code-set usage, same-day screening and diagnostic service reporting, and component-related modifiers.