Question

letter to physician and spreadsheet mapping out results 64 166 HCPCS Level II Coding Mammography Clinic Note: The patient is a 72 year old female who presented today for a mammogram. She stated that she remained up to date with her mammograms, and her records shows compliance with yearly screening exams. The patient stated that when performing her self-breast exam about five days ago, she felt a lump in the upper outer quadrant of the left breast. The Technician asked her to identify the location of the lump, and it was marked with a 1. BB for mammography. The patient was asked to wait until the radiologist had read the initial X- rays. Upon interpretation, there indeed was a suspicious lesion in the-upper outer quadrant of penthe left breast, approximately 1.5 cm Another lesion was found-in the right lower quadrant of qthe right breast. The patient was then asked to undergo additional radiographic views 2unebilaterally for further investigation of the lesions. It was-thought that the lesion in left breast was consistent with malignahcy, and the patient was counseted by the nurse practitioner booldregarding the results of the mammography. The lesion found on the right breast was thought to be fibrocystic breast disease, but the patient.was counseled to speak to a surgeon about this. We contacted the surgeon's office, and the patient was scheduled tomorrow for biopsy and further evaluation as needed. ON Codes: The coder coded G0203 with a modifier of GH Evaluate the codes and determine if the codes are correct. If the answer is not correct, then explain what the correct answer is with supported step by step details. Correct Codes and determination: 0sonbrs HCPCS Level !I

Answer 1

The code is incorrect

Correct code is :-

G0204 -Diagnostic mammography, producing direct digital image, bilateral, all views.

77051 - Computer aided detection with further physician review for interpretation, with or without digitization of film radiographic images, diagnostic mammography.

Code -G0236, has been created for “Digitization of film radiographic images with computer analysis for lesion detection and further physician review for interpretation, diagnostic mammography

Modifier GH is used to indicate diagnostic mammogram converted from screening mammogram .