Radiology: Learn These Rules for Diagnostic vs. Screening Mammography

Why This Topic Matters

Mammography coding affects claim submission, coverage, and compliance when patients present for screening but later receive additional imaging. Understanding the distinction between screening and diagnostic exams helps reduce billing errors and support correct diagnosis reporting.

Article Sections

1. Tip: Extra views don’t automatically change your coding

   Introduces the main coding issue addressed in the article and frames the difference between screening and diagnostic mammography in routine practice.

2. Distinguish Your Definitions

   Reviews payer definitions and Medicare guidance for classifying mammography services, including references to policy language and coverage context.

3. Order requirements

   Summarizes the general order and facility-process considerations discussed for screening and diagnostic mammography under Medicare-related guidance.

4. Diagnosis

   Covers the diagnosis coding references associated with screening mammography for patients with a history of breast cancer, including ICD-9-CM and ICD-10-CM crosswalk references.