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Wiki Icd 9 ultrasound breast

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cheyenne378

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ICD 9 coding for Ultrasound Breast 76645 - for a patient unable to tolerate a mammogram. I work in radiology billing and am having a devil of a time getting these through Medicare. Many of our patients that cannot handle a mam are Mentally Challenged or our older clientele. Does anyone have any ideas they can send my way??
 
Thanks mitchellde

Only problem is they are not accepting 76645 with V76.19. I also tried V76.19 with 319 but that does not fly either. I am not sure where to go from here. But you sure do rock for answering right away! Thanks.
 
probably nothing

There is probably nothing you can do, besides get a waiver signed. If the patient doesn't have an abnormal mammogram or a breast symptom that warrants the Breast Ultrasound, the diagnosis that indicates the mental state of the patient isn't going to do it. And "not being able" to handle a mammogram, sounds to me like they can't handle the "pain" or maybe can't stand that long....If you had a 45 year old that just didn't want to be squished...you wouldn't expect the insurance to pay for the higher priced service....so we really shouldn't expect Medicare to pay for it either.
 
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