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Question:
We did a bilateral diagnostic mammogram on a patient and because of the findings decided to perform an ultrasound-guided breast biopsy on the same day. A unilateral mammogram was done after the biopsy to verify clip placement. Can we code both of the mammograms?
Answer:
There is a national correct coding initiative (NCCI) edit that precludes billing both a bilateral and a unilateral mammogram on the same day. The edit has a “0” indicator, so it cannot be bypassed with a modifier. Since there is no limit to the number of views required for a bilateral diagnostic mammogram, all diagnostic images taken on the same day are considered to be included.
This question was answered in our Breast & Bone Density Procedure Coding Guide. For more hot topics relating to radiology services, please visit our store or call us at 1.800.252.1578, ext. 2.
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