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tci Part B Insider - 2013 Issue 9
Reader Question: Diagnostic vs. Screening X-rays
Question: If we routinely perform extra radiological views on patients with a history of breast cancer, does that mean the exam is diagnostic even if the patient presents for screening?
Answer: Routine performance of extra views for patients with a history of breast cancer is not sufficient to support coding a diagnostic mammogram rather than a screening.
To ensure proper coding, review the payer’s definitions of screening and diagnostic mammography. Also review the rules for when the radiologist may convert a screening exam to diagnostic without an additional physician order.
Diagnostic: For Medicare, "diagnostic mammography is a radiologic...
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