Find comprehensive information on screening mammograms, including CPT codes, ICD-10 codes, clinical documentation requirements, diagnostic imaging, breast cancer screening guidelines, and radiology reporting. Learn about the importance of accurate medical coding for mammogram interpretations, BIRADS classification, and preventative healthcare for women. This resource provides valuable insights for healthcare professionals, coders, and patients seeking information on screening mammography procedures and best practices.
Also known as
Encounter for screening mammogram
Routine mammogram for breast cancer screening.
Other screening mammogram
Mammogram screening for other specified reasons.
Factors influencing health status
Encounters for circumstances other than disease or injury.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the mammogram for screening purposes?
Yes
Is there a personal history of breast cancer?
No
Do NOT code as screening. Determine the reason for the mammogram and code the underlying sign, symptom, or condition.
When to use each related code
| Description |
|---|
| Screening mammogram |
| Diagnostic mammogram |
| Breast ultrasound |
Incorrect coding for unilateral vs. bilateral mammograms (77057 vs. 77056) leading to claim denials or overpayments.
Miscoding diagnostic mammograms (e.g., 77065, 77066) as screening (77057, 77056), impacting reimbursement and compliance.
Incorrect or missing modifiers (e.g., 26, TC, 52) with mammogram codes, causing claim processing issues and audit risks.
Q: What are the current ACR BI-RADS guidelines for interpreting screening mammogram findings and recommending follow-up in asymptomatic women?
A: The American College of Radiology (ACR) BI-RADS Atlas provides standardized terminology and reporting categories for mammographic findings. For screening mammograms in asymptomatic women, the categories range from BI-RADS 0 (incomplete assessment requiring additional imaging) to BI-RADS 6 (known biopsy-proven malignancy). BI-RADS 1 and 2 represent negative and benign findings, respectively, requiring routine screening. BI-RADS 3 signifies probably benign findings with a short-interval follow-up recommended (typically 6 months). BI-RADS 4 denotes suspicious findings requiring tissue diagnosis (biopsy). BI-RADS 5 is highly suggestive of malignancy, also necessitating tissue diagnosis. Adhering to these guidelines ensures consistent interpretation and appropriate management. Explore how S10.AI can integrate BI-RADS reporting into your workflow for improved efficiency and accuracy.
Q: How can I differentiate between normal breast tissue density on a screening mammogram versus areas that might represent masked or obscured breast cancer, especially in dense breasts?
A: Differentiating normal dense breast tissue from masked or obscured cancers on a screening mammogram can be challenging. Dense breast tissue appears white on a mammogram, similar to how cancers appear, making detection more difficult. Supplementary screening modalities, such as digital breast tomosynthesis (DBT) and breast ultrasound, may be considered for women with dense breasts to improve cancer detection rates. DBT acquires multiple low-dose X-ray images from different angles, allowing for 3D reconstruction of the breast and potentially better visualization of obscured lesions. Ultrasound utilizes sound waves to create images and can help characterize masses found on mammography. Consider implementing a risk-based approach for supplemental screening in dense breasts based on individual patient factors. Learn more about how S10.AI can help analyze mammographic density and provide insights for personalized screening strategies.
Patient presents for routine screening mammogram. No personal history of breast cancer. No family history of breast cancer reported. Patient denies breast pain, nipple discharge, skin changes, or palpable masses. Menarche age 13. G0P0. No prior mammograms. No known BRCA mutations. Current medications include a daily multivitamin. Allergies include penicillin. Physical exam of the breasts reveals no abnormalities. Bilateral mammogram performed today demonstrates no suspicious masses, architectural distortion, or microcalcifications. BIRADS 1: Negative. Recommend routine screening mammogram in one year. Patient counseled on breast self-awareness and the importance of regular screenings. Patient verbalized understanding of findings and recommendations.