Wiki mammo w/ clip placement

EikaMTGQueen

Networker
Messages
46
Best answers
0
If a patient has 2 sterotactic biopsies (1 @ 8:00 region & 1 @ 12:00 region) and the patient also has 2 specimens and 2 clip placements. after the clip placements 2 digital unilateral mammos were performed.

The question I have is can you code G0206 x 2 or just 1 unilateral mammo?

thanks: confused:
 
Diagnostic mammo w/biopsies

You would only charge 1 unless one was done as preop and the other post. You would need times documented and/or supportive documentation to support 2 separate times.
 
The mammos are not pre-op, but they are both post-op to the clip placements. They also have both the 8:00 & 12:00 regions on the mammos. i just didnt think you can code 2 mammos.

Thanks
 
If a breast biopsy, needle localization wire, metallic localization clip, or other breast procedure is performed with radiologic guidance (e.g., 76942, 77012, 77021, 77031, 77032), the physician should not separately report a post procedure mammography code (e.g., 77051, 77052, 77055-77057, G0202-G0206) for the same patient encounter. The radiologic guidance codes include all imaging required to perform the procedure



DOES THIS HELP???
:cool:
 
If a breast biopsy, needle localization wire, metallic localization clip, or other breast procedure is performed with radiologic guidance (e.g., 76942, 77012, 77021, 77031, 77032), the physician should not separately report a post procedure mammography code (e.g., 77051, 77052, 77055-77057, G0202-G0206) for the same patient encounter. The radiologic guidance codes include all imaging required to perform the procedure



DOES THIS HELP???
:cool:

AMA and ACR have said for several years now that it is appropriate to code for the post procedure mammogram in most cases as it is a separate exam. There is even an MQSA approved assessment category for post procedure mammograms for marker placement (approved in 2003).
It is Medicare who will find every way they can to deny physicians / facilities appropriate payment, who now says this can't be coded.
 
AMA and ACR have said for several years now that it is appropriate to code for the post procedure mammogram in most cases as it is a separate exam. There is even an MQSA approved assessment category for post procedure mammograms for marker placement (approved in 2003).
It is Medicare who will find every way they can to deny physicians / facilities appropriate payment, who now says this can't be coded.

I have not been able to find those particulars from the ACr but this statement was from the NCCI edits Chapter 9 page IX-10
 
My understanding is that if the report states that the patient was moved to the mammography suite, then a post procedure mammo can be coded.
 
I have not been able to find those particulars from the ACr but this statement was from the NCCI edits Chapter 9 page IX-10

AMA / ACR Clinical Examples in Radiology, Fall 2010; Fall 2008; Fall 2005

Yes, that statement is new in the 2013 NCCI Policy Manual. It has not been in the previous versions.
 
Check the 2014 National Correct Coding Initiative (NCCI) :
If a breast biopsy,needle localization wire,metallic localization clip,or other breast procedure is performed with 'mammographic guidance' (eg,19281, 19282)....
 
Top