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77055 vs. 77057

  1. #1
    Overland Park, KS
    Default 77055 vs. 77057
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    A patient comes into the clinic for a screening mamo performed on the left breast. What is the correct code to report? Would it be 77055 or 77057 -52? I realize that 77057 is for a screening mamo, but what is the difference between these two codes? Is 77055 diagnostic? Thanks.
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P, CRHC, AAPC Fellow

  2. Default
    77055 is a unilateral diagnostic mammogram. I would say it depends on the history, why are you only doing unilateral? Does the patient have a hsitory of cancer, pain, lumps, etc. Usually the screening (77057) is used only if the patient has no history, it would be only a "check-up/screening" or if the patient has had issues e.g. cancer and it has been decided by the ordering doctor and patient that the patient is cleared and can go back to having screening mammograms. Hope this helps.

  3. #3
    Overland Park, KS
    Thanks so much!
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P, CRHC, AAPC Fellow

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