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Tag Archives: Mammography

Screening and diagnostic mammography — retired Part A and Part B LCD

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LCD ID number: L36342 (Florida/Puerto Rico/U.S. Virgin Islands)

After review of the local coverage determination (LCD) for screening and diagnostic mammography, it was determined to retire the LCD based on national coverage determination (NCD) 220.4. 

Therefore, the related coding guideline article is also being retired.

Effective date:

The retirement of this LCD and related coding guideline article is effective for services rendered on or after July 31, 2019.

Click here for future and retired LCDs


Coding Ahead

Mammography Coding Changes for 2018

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Coding for screening mammography furnished to Medicare patients is changed in 2018 as the Centers for Medicare & Medicaid Services (CMS) recognizes three CPT codes added in 2017. G Codes Out, CPT Codes In Effective for services rendered on or after Jan. 1, 2018, you will no longer use HCPCS Level II codes G0202, G0204, and […]
AAPC Knowledge Center

2018 Diagnostic Unilateral Mammography with tomosynthesis

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Hello Coders,
I am asking if any of you have determined which tomosynthesis code to use with code 77065 for a unilateral diagnostic mammogram? We used to use a G0279 for Medicare but that is described as bilateral or unilateral. Are we to use the 77061 (with laterality modifier)?
Thanks for your feedback.
If you would like to contact me directly my number is 802-888-8383 or [email protected] .

Medical Billing and Coding Forum

Stick with G Codes for Medicare Mammography

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The 2017 CPT® codebook introduced three new codes to describe mammography services. Unlike the codes they replaced (77051, 77052, 77055, 77056, and 77057), the new codes specifically include computer-assisted detection (CAD), when performed: 77065 Diagnostic mammography, including computer-aided detection (CAD) when performed; unilateral 77066 Diagnostic mammography, including computer-aided detection (CAD) when performed; bilateral 77067 Screening […]
AAPC Knowledge Center

Stick with G Codes for Medicare Mammography

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The 2017 CPT® codebook introduced three new codes to describe mammography services; 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 Unlike the codes they replaced (77051, 77052, 77055, […]
AAPC Knowledge Center

Maximize Mammography Coding and Billing Efficiency in 2017

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Maximize Mammography Coding and Billing Efficiency in 2017

Medicare publishes its rules and requirements for the coding and billing of medical procedures to obtain reimbursement under its programs, but many commercial insurers are not as transparent about their own requirements. This leaves medical billing professionals in the dark when there are new procedure codes or changes to existing coding in the American Medical Association’s CPT® code set or by federal regulation.  Such is the case with mammography coding for 2017.  Below we have summarized the key coding considerations for radiology practices billing mammography services this year. (Click here to read our complete article on the 2017 coding changes impacting diagnostic and intervential radiology.)


Radiology Billing and Coding Blog

Mammography Claims Require More than Correct Coding

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Screening mammography is a radiologic procedure used for early detection of breast cancer. Medicare has provided Part B coverage of screening mammography for women since 1991. Mammography Code Changes For 2017, CPT® codes 77051, 77052, 77055, 77056, and 77057 are deleted. New codes for these radiology services bundled with CAD are: 77065 Diagnostic mammography, including computer-aided detection […]
AAPC Blog