June 30, 2011

ºÚÁÏÍø Radiology Coding Sourceâ„¢ for May-June 2011 Q and A

Q: In the January/February 2011 ºÚÁÏÍø Radiology Coding Source it stated that it is appropriate to use the unlisted code 76499 to describe digital breast tomosynthesis.  Would you clarify if the full-field digital mammography code is reported separately or is it included in the unlisted code?

A: Breast tomosynthesis performed in conjunction with digital mammography is appropriately reported with the unlisted diagnostic procedure code 76499 to describe breast tomosynthesis and one of the HCPCS Level II “G” codes (G0202, G0204, or G0206) to describe the full-field digital mammography performed. If computer-aided detection (CAD) also is performed, it should be reported separately using one of the mammography CAD codes, 77051 (CAD performed in conjunction with diagnostic mammography) or 77052 (CAD performed in conjunction with screening mammography).  It is not appropriate to report a three-dimensional reconstruction code in conjunction with the full-field digital mammography code.