Forum - Questions & Answers

Apr 23rd, 2009 - tbscpc 2 

Mammo to check clip placement

Is it appropriate to charge a 2 View (single breast) mammography that was performed to check the clip placement after a biopsy?

Apr 23rd, 2009 -

with no qualifications...

I would say bill a diagnostic mammogram

Apr 24th, 2009 - nmaguire   2,606 

metallic clip

There are times where "you need the whole picture" and this is best answered with the procedure note. Example:
The coding for a mammogram following a vacuum-assisted, image-guided breast biopsy and tissue marker placement would depend on the imaging modality used, as well as the number of physicians involved. A vacuum-assisted, image-guided breast biopsy is appropriately reported with code 19103 (Biopsy of breast; percutaneous, automated vacuum assisted or rotating biopsy device, using imaging guidance) for the biopsy, 77031 for the stereotactic localization (radiologic supervision and interpretation, which includes all imaging), and 19295 for the placement of the tissue marker.
If all of the imaging takes place on a stereotactic machine and is performed by the same physician, the postprocedure mammogram is included in code 77031. Code 77031 includes all of the imaging and work involved by a physician to perform this procedure.
Therefore, it is not appropriate to code for the follow-up mammogram.
There are instances, however, when it would be appropriate to code separately for a mammogram post breast biopsy. For example, it is appropriate to bill for a verification mammogram if the biopsy is done under ultrasound guidance. The rationale for this is that the mammogram is a separate procedure using a different imaging modality and it is not essential to the successful completion of the ultrasound-guided procedure.
Another instance when it would be appropriate to code separately for a follow-up
mammogram is when a surgeon does the stereotactic procedure and clip placement, and then refers the patient to radiology for a follow-up mammogram or ultrasound. In this instance, it is appropriate for the radiologist to code for the mammogram or ultrasound study performed. This is one of many examples where coding is dependent on whether there is one or multiple physicians involved in the steps of the procedure



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