Question:

Can we report 77067-52-LT and 77065-RT together for a screening mammogram on the left breast and a diagnostic mammogram on the right breast? The patient feels a lump in her right breast, but it’s time for her annual screening mammogram so her doctor wants to complete a screening on the left side.

Answer:

No, you can’t report a diagnostic mammogram on one breast and at the same session perform a screening mammogram on the other breast. The definition of a screening mammogram is a radiologic procedure provided to an asymptomatic woman for the purpose of early detection of breast cancer. If a patient has symptoms prompting a diagnostic mammogram, she does not qualify for a screening. Whether the problem is in one breast, or both doesn’t matter. If you have orders for one breast diagnostic and done screening, you must clarify with the ordering physician prior to performing the exam. It can’t be both; it must be one or the other. Screening can resume once the problem is resolved. See the ACR Radiology Coding Source for May/June 2013 for a Q & A regarding this situation.

This question was answered in an edition of our Radiology Compliance Manager. 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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