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Screening & DX mammo done same day

Tierni Posted Tue 23rd of October, 2018 19:02:25 PM
Can a screening mammogram(77067) and a diagnostic mammogram(77065 or 77066) be billed the same day? By the same provider? CCI edits checker shows a modifier can unbundle, but will the insurance go for that?
SuperCoder Answered Wed 24th of October, 2018 02:46:47 AM

Hi Lori,

  • CPT Code 77067 (screening mammogram) and 77065/77066 (diagnostic mammogram) can be billed the same day under certain circumstances.
  • According to NCCI edits, “Screening and diagnostic mammography are normally not performed on the same date of service''
  • However, when the two procedures are performed on the same date of service, Medicare requires that the diagnostic mammography CPT code to be reported with modifier GG (performance and payment of a screening and diagnostic mammogram on the same patient, same day) and the screening mammography CPT code be reported with modifier 59”.
  • Hence if diagnostic and screening mammography performed on same date of service, then correct coding for the scenario will be : 77065/77066 with GG modifier and 77067 with modifier 59.

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