How do you code for a screening mammogram when additional magnification views are required for a suspected abnormality? May I code both a diagnostic mammogram and a screening mammogram?
If a screening mammogram is performed and, after film review, pathology is suspected, and additional views are taken, it would be appropriate to charge for both a screening mammogram and a diagnostic mammogram. When the additional diagnostic views are done on the same day as a screening mammogram, Medicare requires that providers append modifier GG to the diagnostic mammography CPT® or HCPCS code used to designate that a screening procedure was performed in conjunction with a diagnostic procedure. Modifier 59 should be added to the screening mammogram code.
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.