screening mammograms


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Attention all Radiology Experts out there! Can you help with something regarding screening mammograms (cpt 77057) with ABNORMAL FINDINGS OR

Scenario is as follows: Referral for patient to have annual bilateral screening mammogram but patient has symptoms of pain, lump, nipple discharge, etc.
How should this be coded? Do you code the V76.___ first and then lump or
pain or other symptoms 2ndary? Do you need to still use CPT 77057 or can
you change it to 77056 for diagnostiic mammo in these instances?

In a patient with hx of breast ca, should we be coding V76.11 as primary diagnosis?

Any and all help would be appreciated.
Claudia K
If you code the lump primary and personal history 2ndry then you can use 77056 w/ the add on code 77051 as a diagnostic mammo and not use the 77057 which would be used for annual, no signs or symptoms type of mammo.
Screening Mammos

So you are saying I would be correct in changing the CPT code from 77057 to
77056 in these instances where the referring drs send them to us as just annual screening mammograms but when they get here they tell the techician
they have pain breast, lump, hx of breast ca. whatever.

Now the problem I have is that transcription has these mammograms still listed as screening mammography on the report, so if I change the cpt code to 77056 for diagnostic, would I also have to have transcription change the
heading of the radiology report???

Claudia K
If the exam is already done you cannot change it. If the patient has symptoms your center needs to call the referring doctor for a revised order for a diagnostic mammogram.........if patient has history of breast cancer or family hx of cancer then yes you should always code V76.11 as primary and either V16.3 (family hx) or V10.3 (personal hx) as secondary.

Jennifer L. Davidson, CPC
No, you go off what the physician referrs the patient in for the mammo. If it's truly a annual screening then you'd code the 77057, but if the pt states something else, we in administration can't change it to dx if it's not from the physician's order. If the pt wants they can phone the office to get a revised order. If the physican refers for lump, discharge and personal hx of breast CA, then we'd use the 77056 code.