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Screening Mammograms Leading to Breast Ultrasound

  1. Exclamation Screening Mammograms Leading to Breast Ultrasound
    Medical Coding Books
    Hi everyone,

    In our IDTF, we perform digital mammograms. There are times when these lead to additional films, or a diagnostic mammogram on the same day, or the next. Right now I'm needing to find written documentation indicating whether the radiologist can order a breast ultrasound, after abnormal mammogram findings, without a written order from the patient's provider. I'm telling the IDTF no, however I don't want to stop them if I'm incorrect in my answer. Anyone able to direct me to information other than Medicare mammogram guidelines or ACR mammogram guidelines?



  2. Smile
    You can find documentation for ordering diagnostic tests at car/3b15000.asp on Medicare's web site. (Carriers Manual-Part3-ChapterXV)

  3. Default
    Thanks! I have been there. Even BCBSM can't give a direct answer. As the imaging center is registered an IDTF with Medicare, my company has to be very specific about our policies.

    The interpretation I ended up coming up with for 'additional images' was to mean of the same type as originally ordered and there must be an order in place prior to performing a breast ultrasound. Also, that if on the order form there is an area for an ordering provider to check off that if the digital mammogram shows "____" (whatever the radiologists determine the x factor to be in these cases, and it should be standard), then it would be ok to proceed with a breast ultrasound at the same date and time.

    Thanks again for being so thoughtful to provide a link.


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