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Radiology Coding Alert

Reader Question:
Check Payer Policy for Unilateral Screening Mammogram Reporting

Question: What is the correct way to code a unilateral screening mammogram? We’ve been receiving denials from our Medicare Administrative Contractor (MAC) using modifier 52. Pennsylvania Subscriber Answer: You are correct in reporting modifier 52 (Reduced Services) alongside 77067 (Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed). The American College of Radiology (ACR) explains that “because the [...]

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