Mammogram is done to check any abnormal finding present in the breast area. In US, due to breast cancer, female residents are periodically goes for a screening exam. This exam is just a routine checkup to be aware of any preventive measure for breast cancer. This screening exam is called as screening mammogram. CPT code for digital screening mammogram is frequently used in medical coding. Since, the exam is done periodically hence we get a lot of reports of screening mammogram. Their are new CPT codes for diagnostic and screening mammogram in 2017. We will be having bundle CPT codes this time, so let us checkout the new CPT codes changes in mammogram in Radiology facility.
New CPT codes from 2017 for Mammogram
New codes are introduced in 2017 for diagnostic and Screening Mammogram. These new CPT codes will be bundle with computer-aided-detection (CAD) and mammography. The old CAD and mammography codes 77051, 77052, 77055, 77056, and 77057 will be deleted in 2017. Same applies with the HCPCS Level II G codes G0202, G0204 and G0206 will be deleted as well in 2017. Below are the new CPT codes in 2017 for diagnostic and Screening Mammogram.
77065 Diagnostic mammography, including computer-aided detection (CAD) when performed; unilateral
77066 Diagnostic mammography, including computer-aided detection (CAD) when performed; bilateral
77067 Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed
Deleted CPT codes for digital Screening Mammogram & Diagnostic Mammogram
The patient, which has any abnormal finding in breast like breast mass or lump, calcification, micro calcification, cyst in breast etc. are generally goes for Diagnostic mammogram. If the physician is suspicious about the abnormal finding then they can go for breast biopsy also. The biopsy procedure will help to know the exact nature of the abnormal finding present in breast. Hence, the difference between the both diagnostic and screening mammogram is very simple, during screening exam present do not have any abnormal or suspicious finding in breast, on the contrary diagnostic exam is done when there are any abnormal or suspicious finding are present in breast. Now, let checkout the CPT code for digital screening mammogram and diagnostic mammogram.
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|Procedure Description||Digital Exam CPT code Bilateral||Digital Exam CPT code Unilateral||Non-digital exam CPT code Bilateral||Non-digital exam CPT code Unilateral||CAD code|
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ICD 9 & 10 codes used with CPT code for digital screening mammogram
There are only two icd codes used with Screening mammogram, V76.12 and V76.11. These two V codes are used for High-risk patient (V76.11) and Normal patient (V76.12). The high-risk patients are those, which have any past history or family history of breast cancer. Normal Patients do not have any history or family history of breast cancer. These two V codes should be used with CPT code for digital screening mammogram. The common icd codes used with diagnostic mammogram are breast mass or lump (611.72), abnormal mammogram (793.80), breast calcification (793.89) and breast micro calcification (793.81).
V76.12 – Z12.31 Encounter for screening mammogram for malignant neoplasm of breast
V76.11- Z12.31 Encounter for screening mammogram for malignant neoplasm of breast
611.72 – N63 Unspecified lump in breast
793.80 – R92.8 – Other abnormal and inconclusive findings on diagnostic imaging of breast
793.81 – R92.0 – Mammographic microcalcification found on diagnostic imaging of breast
793.89 – R92.8 – Other abnormal and inconclusive findings on diagnostic imaging of breast
CAD code bundled with CPT code for Digital Screening Mammogram
The CAD is referred as Computer Aided Detection. It is generally used with digital diagnostic and screening mammogram. The CAD is mostly used with mammogram. The CAD code is now bundled with diagnostic mammogram and with screening mammogram procedure codes from 2017.