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Screening vs diagnostic mammogram

  1. Default Screening vs diagnostic mammogram
    Medical Coding Books
    Scenario - Pt calls her PCP and states she feels a lump in her breast. She has never had a mammogram. The pt is sent directly to x-ray without examination by her PCP for a mammogram. Should this mammogram be done as screening, screening changed to diagnostic if necessary or diagnostic?

  2. Default
    This should be diagnostic because there is a palpable lump (611.72)

    It does not matter how many or if no mamograms have ever been done

  3. Default
    But doesn't it matter that she was not examined by a doctor and that it was only the patient's opinion that she had a lump?

  4. Default
    as long as her pcp sent a rx for the dx is does not matter that she did not see him, she is symptomatic which makes the mammo a diagnostic.

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