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Tanya Posted 1 Year(s) ago
Patient with implants coming in for their annual mammogram with no complaints and and their mammogram is normal, can we use an additional view(G0204) due to the fact the implants interrupts the view of the tissue. This would be the codes: diagnosis is Z12.31 G0202 77063 G0204 Thanks you
SuperCoder Posted 1 Year(s) ago

HELLO

You should not use number of views as a criterion to distinguish between screening and diagnostic. Screening mammography usually has two views craniocaudal (CC) and mediolateral oblique (MLO). However, you should not use the number or type of views to differentiate a screening mammogram from a diagnostic one. A patient in for a screening may require more than two views in certain situations, but you should still code the service as a screening. So according to above scenario, appropriate codes would be:

  • CPT code G0202 {Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed}
  • CPT code 77063 {Screening digital breast tomosynthesis, bilateral (List separately in addition to code for primary procedure)} which is an add-on code for tomosynthesis.
  • ICD-10 Z12.31 dx code

Also ensure following points in order to bill diagnostic mammography:

  • Physician order for the diagnostic service
  • Signs and symptoms supporting medical necessity
  • Personal history or other factors based on which your physician decides a diagnostic service

HOPE THIS HELPS!

Posted by Tanya, 1 Year(s). There are 2 posts. The latest reply is from SuperCoder.

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