Wiki Diagnostic Vs. Screening Mammography

[screed@urhcs.org]

I am in an argument at work. If a patient with a history of breast cancer, but does not have current symptoms or problems, comes in for their yearly mammogram, how would you code it? Would you use 77057 for the screening or would you use the 77055 or 77056 depending on if they have had a mastectomy? Any help would be greatly appreciated.

 

[angeleyzs86]

I use 77057 with diagnosis of V76.11, if she isn't coming in with any symptoms or to follow up on the breat cancer. Hope this helps!

 

[screed@urhcs.org]

What do you use for the procedure code if they have had a mastectomy? The code 77057 states that it is a bilateral proceure, with 2 views of each breast.

 

[LScottCPC]

How is the exam being ordered by the referring physician? It is my understanding that the radiologist is under an obligation to perform the exam based on what the referring has ordered. Some doctors considered a pt who has had breast cancer to always and forever have breast cancer, others will allow them to go back to screening mammos after a couple of years with no recurrences. Hope this helps!

 

[Lisa Bledsoe]

What do you use for the procedure code if they have had a mastectomy? The code 77057 states that it is a bilateral proceure, with 2 views of each breast.

We append modifier -52.