Results 1 to 5 of 5

G0202 with 77052 and 77056-GG billed on the same day

  1. #1
    Exclamation G0202 with 77052 and 77056-GG billed on the same day
    Medical Coding Books
    Hi,

    I have a question for people coding mammograms, can we bill use G0202 and 77052 (for CAD) and have a diagnostic mammogram 77056 (with GG) billed on the same day. I am facing denials from some commercial carriers when we bill G0202 (digital screening) 77052 (CAD) and 77056-GG (bilateral diagnostic) on the same day, could not find any reference on the net, need help on this urgently.
    Regards,

    Sudip Rai
    CPC-H ""

  2. Default Coding for screening and diagnostic mammos same day
    We will often bill for screening and diagnostic on the same visit, and as
    far as I know, it's never been a problem. Often a problem is seen with the
    screening, so they do the diagnostic, and I just code it that way, with the screening code, and the abnormal mammo code.

  3. #3
    Default
    This is how I have been coding the screening and diagnostic mammogram with GG modifier appended to the diagnostic mammography code, we are getting denials infrequently from Medicare or some commercial insurances.
    Regards,

    Sudip Rai
    CPC-H ""

  4. Talking additional Question re: G0202
    We recently added the equipment to perform Digital Mammograms to our office. We have noticed higher reimbursment from all payers with the exception of one. We contacted that payer and we were advised that there is an addtional code that we should be submitting to receive full reimbursement but she would not tell us what that is.

    After reading many of the posts on this site I wonder if she is refering to the CAD code. We no longer have the equipment for the CAD but I just want to be sure that we aren't missing out on something.

    Any help is greatly appreciated.


  5. #5
    Location
    Alexandria, LA
    Posts
    518
    Default
    Quote Originally Posted by sudip.rai View Post
    Hi,

    I have a question for people coding mammograms, can we bill use G0202 and 77052 (for CAD) and have a diagnostic mammogram 77056 (with GG) billed on the same day. I am facing denials from some commercial carriers when we bill G0202 (digital screening) 77052 (CAD) and 77056-GG (bilateral diagnostic) on the same day, could not find any reference on the net, need help on this urgently.
    You are doing digital screening, but film diagnostic?
    Which is getting denied, and what denial reason?
    For Medicare at least, your facility must be certified for digital and/or film. If you are only certified for digital, you won't get paid for film and vice versa.
    What diagnosis codes are you using on each?

Similar Threads

  1. CPT 85610- billed twice in one day?
    By Spunkyluvnmo2 in forum Medical Coding General Discussion
    Replies: 3
    Last Post: 02-26-2015, 02:40 PM
  2. two colons billed on same day
    By tpontillo in forum Gastroenterology
    Replies: 3
    Last Post: 08-09-2011, 06:05 PM
  3. Help!!! 77052 denials
    By jdd111168 in forum Interventional Radiology
    Replies: 5
    Last Post: 08-19-2008, 03:27 PM
  4. 62318 billed twice in one day?
    By sslovisone in forum Anesthesia
    Replies: 1
    Last Post: 06-10-2008, 12:53 AM

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?

Login

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.