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Mammo Screening and Diagnostic Same Day

Tanya Posted Mon 25th of June, 2018 13:51:09 PM
Patient has a screening mammogram with a 3D imaging and the radiologist does a diagnostic mammogram on the same day. These are the code we've been submitting 77067-59, 77063-59, 77065-GG. Medicare covers these codes. I understood we only need one 59 modifier on just the 77067. I need clarification.
SuperCoder Answered Tue 26th of June, 2018 02:32:21 AM

Hi Tanya,

As per CCI edits, modifier 59 is correctly appended to 77067 and 77063. When submitting a claim for a screening mammography and a diagnostic mammography for the same patient on the same day, attach Modifier GG to the diagnostic mammography. For further reference consider the following link :

https://downloads.cms.gov/medicare-coverage-database/lcd_attachments/20059_13/l20059l20060l20061l20062_rad005_cbg_040111.pdf

Further query is welcome.

Good day.

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