What to expect when getting a screening mammogram
The CPT codes used for screening mammography:
When submitting a claim for a screening mammography and a diagnostic mammography for the same patient on the same day, attach Modifier GG to the diagnostic mammography. To bill the technical component, only, use modifier TC. To bill the professional component, only, use modifier 26. When billing a global fee, no modifier is needed.
31: Encounter for screening mammogram for malignant neoplasm of breast.
For example, Z12. 31 (Encounter for screening mammogram for malignant neoplasm of breast) is the correct code to use when you are ordering a routine mammogram for a patient. However, coders are coming across many routine mammogram orders that use Z12. 39 (Encounter for other screening for malignant neoplasm of breast).
DIAGNOSIS CODES The proper diagnosis code to report would be Z12. 31, Encounter for screening mammogram for malignant neoplasm of breast.
Z12. 31 (Encounter for screening mammogram for malignant neoplasm of breast) is reported for screening mammograms while Z12. 39 (Encounter for other screening for malignant neoplasm of breast) has been established for reporting screening studies for breast cancer outside the scope of mammograms.
NOTE: Mammograms will not interfere with your ICD or S-ICD. However, your device could be damaged if it gets compressed in the mammogram machine. Make sure the doctor or technician knows you have an implanted device.
What is a mammogram? A mammogram is an x-ray picture of the breast. Mammograms can be used to check for breast cancer in women who have no signs or symptoms of the disease. This type of mammogram is called a screening mammogram. Screening mammograms usually involve two or more x-ray pictures, or images, of each breast.
ICD-9 Code V76. 12 -Other screening mammogram- Codify by AAPC.
CPT: 7706352 SCREEN TOMO UNI (Screening 3D exam of one breast. Charged when the patient has no signs or symptoms of breast cancer and exam is for screening purposes only.
Z12. 11: Encounter for screening for malignant neoplasm of the colon.
9.
Z12.11. Encounter for screening for malignant neoplasm of colon.
Diagnostic Mammography: Diagnostic mammography includes additional x-ray views of each breast, taken from different angles and if performed digitally, may be manipulated, enlarged, or enhanced for better visualization of the abnormality found during screening mammography.
Screening Mammography: Screenings are performed on otherwise healthy individuals to look for cancer or precursors to cancer of the breasts.
In general, screening mammograms are not recommended for women under 40 years of age, in part because breast tissue tends to be more dense in younger women, making mammograms as a screening tool less effective.
CAD: Computer-Aided Detection (CAD) is a computer-based process that is used in conjunction with digital mammography to analyze mammographic images and identify suspicious areas by marking them and bringing them to the radiologist's attention.
There is a technique that technicians should be trained in that allows them to better visualize breast tissue surrounding the implants called 'implant displacement views .'. Patients with implants after mastectomy should have orders that clarify if the physician wants the reconstructed breast to be screened as well.
Report code V76.12 (Screening for malignant neoplasms, other screening mammogram) for all other screening mammography. If the patient has a personal history of breast cancer, has completed active treatment and is back to annual mammographic screening, report V76.11.
Digital mammography is when images are taken and saved to a computer, which can then be enhanced, magnified, and manipulated as needed to aid in a more accurate diagnosis of early stage breast cancers or patients with very dense breast tissue.