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Radiology Coding Alert

Coder to Coder

Don't diminish the importance of Medicare's screening mammogram frequency regulations, says Stacy J. Hardy, CPC, coding specialist with Sierra Vista Diagnostics in Arizona. "Screenings are only covered a year and a day apart," she explains.

If a patient wants to come in early for convenience's sake, e.g., to avoid travel conflicts, Medicare won't cover the early screening, so you must have the patient sign an advance beneficiary notice (ABN) that indicates that the patient is responsible for paying the bill.

Further, if your office doesn't have access to a patient's films because they are at another facility, don't assume enough time has passed to perform another screening mammogram. If you perform a screening mammogram and then later find out once you have received the records from the other facility that a year and one day (366 days) have not passed since the last screening, chances are you are going to have trouble getting paid, especially if the patient was not asked to sign an ABN.  

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