decisionhealth Newsletters, Answer Books - 2009 Issue 2 (February)
Radiology Services / Additional mammography views ordered by a radiologist
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Article Overview
This article covers radiology billing guidance for mammography scenarios in which a screening study leads to additional diagnostic imaging ordered by the radiologist during the same session. It discusses claim reporting, the roles of the treating and ordering physicians, and the use of mammography procedure codes and a modifier in the screening-to-diagnostic context. The content is intended for radiology coders, billing staff, and other professionals handling mammography claims and Medicare-related reporting.
Why This Topic Matters
Mammography claims can involve different billing paths depending on whether the exam remains screening or is converted to diagnostic imaging. Understanding the article helps coders and billers apply the correct claim structure and recognize the reporting considerations involved in radiologist-initiated additional views.
What You Will Learn
- How mammography claims are handled when additional views are ordered after an initial screening exam
- How physician roles are described in the billing scenario
- How screening-to-diagnostic mammography situations are reported at a high level
- What kinds of mammography procedure coding and modifier usage are discussed
Who Should Read This
- Radiology coders
- Medical billers
- Outpatient imaging staff
- Compliance staff
- Revenue cycle professionals
Codes Discussed
Modifiers Discussed
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