AAPC - Back to school
Results 1 to 2 of 2

Thread: Screening mammo vs diagnostic mammo

  1. #1

    Default Screening mammo vs diagnostic mammo

    AAPC: Back to School
    AS I understand it, if a doctor orders a screening mammo, that is what our radiologist must do. We have had instances where, based on a questionnaire the patient fills out, the radiologists changes the screening to a diagnostic. I know with Medicare we can bill both on the same day with a modifier GG on the diagnostic. My question has more to do with PPO and fee for service insurances.

    Our radiology department is insisting that according to radiology guidelines, since the patient answered on a questionnaire that they may at risk for breast ca (ie family hx of breast ca) they have the right to only do a diagnostic mammo even thought the order was for a screening!?!

    Any help would be appreciated

  2. #2
    Join Date
    Apr 2007
    Columbia, MO


    No the guidelines are clear on this, the visit is screening if that is what was ordered, diagnostic is for when the patient is symptomatic and we are looking for a definitive diagnosis as the causation. Even if the patient expresses family hx then it is still screening with family hx secondary. The guidelines that screening remains first listed regardless of the finding or any other procedure performed due to the findings(at the same session.)

    Debra A. Mitchell, MSPH, CPC-H

Similar Threads

  1. Question re diagnostic mammo vs screening
    By karen747 in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 08-28-2014, 02:25 PM
  2. mammo screening vs diagnostic
    By phamilton in forum Interventional Radiology
    Replies: 2
    Last Post: 01-30-2013, 06:39 PM
  3. screening mammo vs diagnostic
    By phamilton in forum Interventional Radiology
    Replies: 3
    Last Post: 01-28-2013, 11:37 AM
  4. Screening/Diagnostic Mammo Same Day
    By dballard2004 in forum Modifiers
    Replies: 6
    Last Post: 04-06-2011, 01:16 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.