Don't Get Left Behind as Mammography Goes Digital
Published on Mon Sep 25, 2006
Keep your HCPCS book close to stay out of trouble
New technology is making it more cost-effective than ever before to switch from analog to digital mammography, which means you need to get used to using new codes, too.
You can code digital mammograms like a pro the first time. Here's how. Differentiate Between CAD and Direct Digital Radiologists use CAD (computer-aided detection) to scan analog mammograms, usually converting them to digital data, to analyze the images for suspicious areas.
Direct digital mammography replaces the x-ray film with sensors that convert x-rays into electrical signals that produce an image on a computer screen or print on special film. Add These Codes for CAD The CPT manual has two add-on codes for mammograms, says Kim Garner Huey, CPC, CCS-P, CHCC, Alabama coding consultant and professional medical coding curriculum instructor in her audioconference for The Coding Institute, "Coding, Documentation, and Reimbursement Guidance for Breast Procedures":
• +76082--Computer-aided detection (computer algorithm analysis of digital image data for lesion detection) with further physician review for interpretation, with or without digitization of film radiographic images; diagnostic mammography
• +76083--... screening mammography. Remember: Add-on codes "describe additional intra-service work associated with the primary procedure," performed by the same physician, according to CPT guidelines.
Put it in practice: Code 76082 includes a note to report the code in conjunction with analog diagnostic mammography codes 76090 (Mammography; unilateral) or 76091 (...bilateral). So, for a unilateral analog diagnostic mammogram with CAD, you should report 76090 and 76082. For a bilateral analog diagnostic mammogram with CAD, report 76091 and 76082.
Don't forget: NCCI 12.3 goes into effect Oct. 1. We'll cover the changes you need to know in next month's issue.
Code 76083 includes a note to use it in conjunction with 76092 (Screening mammography, bilateral [two-view film study of each breast]). So for a bilateral analog screening mammogram with CAD, you should report 76092 and 76083.
Watch for: The radiology report must document that "Computer-aided diagnosis was utilized for this exam," says Barbara Rutigliano, MS, RT(R), CPC, RCC, coding manager for Jefferson Radiology in East Hartford, Conn. Look to G Codes for Direct Digital
When coding for mammography using direct digital imaging, as opposed to analog imaging, you should use the following codes, Rutigliano says:
• Screening Mammography: G0202--Screening mammography, producing direct digital image, bilateral, all views
• Diagnostic Mammography, Bilateral: G0204--Diagnostic mammography, producing direct digital image, bilateral, all views
• Diagnostic Mammography, Unilateral: G0206--Diagnostic mammography, producing direct digital image, unilateral, all views. Important: The radiology report must document that "direct digital imaging was utilized for this exam," Rutigliano says.
Tip: You can use add-on codes 76082 and 76083 with digital mammography, as well as analog mammography, she says.
Rutigliano offers up examples of typical reports for these services:
Typical report for digital [...]
