tci Outpatient Facility Coding Alert - 2013 Issue 3

Radiology: Learn These Rules for Diagnostic vs. Screening Mammography

Tip: Extra views don’t automatically change your coding. Facilities sometimes have policies stating that the staff should automatically get extra views when a patient with a history of breast cancer comes for a mammogram. The question for coders is: Do the extra views mean the exam is diagnostic even if the patient presents for a screening? The short answer: Routine performance of extra views for patients with a history of breast cancer is not sufficient to support coding a diagnostic mammogram (77055, Mammography; unilateral or 77056, … bilateral)  rather than a screening (77057, Screening mammography, bilateral [2-view film...

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