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Thread: Mammograms

  1. #1

    Question Mammograms

    AAPC: Back to School
    I would like to know when a patient comes in day one for screening, the mass is indeterminate, patient is then requested to return another day to do additional views, is day one consider screening and the second day is considered a diagnostic? Or is the day one(patient initial dos) service billed as a diagnostic and not worry about day two.

  2. #2
    Join Date
    Apr 2007
    Louisville, KY


    If the patient presents for a screening mammogram and one is performed, it is coded as screening.

    Diagnostic mammograms are those done for any abnormality or perhaps patient symptom or history. Diagnostic mammograms are usually those ordered after a screening has been performed--even if that screening had an abnormal impression.

    So, to make a long story short, from a CPT standpoint, both should be coded as they were ordered (screening versus diagnostic). For ICD I would code the primary reason for the order and/or any impression stated by the reading Radiologist, following the stated guidelines of ICD on that matter.

    Hope this helps.
    Kevin B. Shields, RHIT, CPCO, CCS, CPC, COC, CCS-P, CPC-P, CPC-I

  3. #3



    Just so I am clear, if the patient is to return for additional views on day two, day two will be coded as a diagnostic then?

  4. #4
    Join Date
    Apr 2007
    Louisville, KY


    Yes, the purpose of the second set of views is for diagnostic purposes.
    Kevin B. Shields, RHIT, CPCO, CCS, CPC, COC, CCS-P, CPC-P, CPC-I

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