I have a mammogram report that describes a nodule of 11*9 mm with obscured margins, in the impression says "Bi Rads O- Incomplete mammogram" with recommendation of US of breast. Should I code the breast nodule or BI-RADS 0 (R92.2)? thank you
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Tag Archives: Mammogram
Denials on Unilatera Breastl Mammogram Screenings with Tomosynthesis
We have been getting denial on patients that come in for annual mammogram screenings with Tomosynthesis. These patients have had a unilateral mastectomy. For example, the patient came in for a Mammogram screening with Tomosynthesis of the left breast we would code is as follows:
77067-52, LT, Z85.3 (hx of breast CA), Z90.11 (absence of right breast)
Is this correct? This is how we coded them, and recently we have been getting denials. Please help!! 
Mammogram Screening
I received a denial from Medicaid when using CPT code 77067. They stated that I needed to add a modifier on it. I was under the impression that since the code it self is for a bilateral screening that it doesn’t require a modifier. No other carriers are requesting a modifier for this code. Can someone please give me some insight on this?
2018 CPT code changes for Mammogram
Effective for claims with dates of service on or after January 1, 2018, the HCPCS codes G0202, G0204 & G0206 will be replaced by the following CPT codes:
77067 – “screening mammography, bilateral (2-view study of each breast), including CAD when performed”
77066 – “diagnostic mammography, including (CAD) when performed; bilateral” and
77065 – “diagnostic mammography, including CAD when performed; unilateral”.
As part of the January 2017 HCPCS code update, code G0389 was replaced by CPT code 76706. Type of Service (TOS) “5” was assigned to 76706, and the coinsurance and deductible were waived.
Effective January 1, 2018, the TOS for 76706 will be changed to “4” as part of the 2018 HCPCS update; the coinsurance and deductible will continue to be waived.
New Mammogram code 77067
I work for a Radiologist and we are receiving denials for the new Mammogram code 77067. Has anyone else been receiving denials? Any suggestions? Both Medicare and commercial insurance are denying.
Thanks in advance.
Thanks in advance.
Tina