Find comprehensive information on Screening Mammography, including CPT codes, ICD-10 codes, clinical documentation requirements, and healthcare guidelines. Learn about diagnostic imaging, breast cancer screening, and preventative care protocols. This resource provides detailed information for physicians, radiologists, medical coders, and other healthcare professionals involved in the accurate documentation and coding of screening mammograms. Explore best practices for optimizing reimbursement and ensuring compliance related to this essential preventative health service.
Also known as
Encounter for screening mammogram
Routine mammogram for breast cancer screening.
Other screening mammograms
Screening mammograms not otherwise specified.
Abnormal mammogram finding
Suspicious findings on a mammogram requiring further evaluation.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the mammography for diagnostic purposes?
Yes
Do NOT use a screening code. Code the underlying sign, symptom, or condition.
No
Is there a personal history of breast cancer?
When to use each related code
| Description |
|---|
| Screening mammogram |
| Diagnostic mammogram |
| Breast ultrasound |
Incorrect coding for unilateral vs. bilateral screening mammograms (e.g., using 77057 for both breasts instead of 77056).
Miscoding diagnostic mammograms (e.g., for a palpable lump) as screening, leading to incorrect reimbursement and potential compliance issues.
Incorrect or missing modifiers (e.g., -26, -TC, -52) impacting payment and potentially triggering audits.
Q: What are the current ACR appropriateness criteria for ordering a screening mammogram in asymptomatic women with dense breasts and a family history of breast cancer?
A: The American College of Radiology (ACR) Appropriateness Criteria recommends annual screening mammography starting at age 40 for women with dense breasts and a family history of breast cancer. While dense breast tissue can make it more challenging to detect abnormalities on mammography, it is also associated with a slightly increased risk of breast cancer. A family history of breast cancer, particularly in first-degree relatives, further elevates this risk. Therefore, annual screening is crucial for early detection. For women with extremely dense breasts, supplemental screening with ultrasound or MRI may be considered after discussing the risks and benefits with the patient. Explore how our S10.AI platform can integrate ACR guidelines into your clinical workflow for streamlined decision-making.
Q: How do I interpret BI-RADS 4 and 5 findings on a screening mammogram in a patient with a history of breast augmentation?
A: Interpreting BI-RADS 4 and 5 findings on a screening mammogram in a patient with breast augmentation requires careful consideration of the implant type and placement. While implants can sometimes obscure breast tissue, BI-RADS 4 (suspicious abnormality) and BI-RADS 5 (highly suggestive of malignancy) classifications still warrant further investigation. This typically involves additional imaging such as targeted ultrasound, diagnostic mammography with special implant displacement views (Eklund views), or MRI. Correlation with prior mammograms is also essential. Consider implementing a structured reporting system to document findings and recommendations accurately. Learn more about how S10.AI can assist with image analysis and reporting in complex cases like these.
Screening mammography performed on [Date] for [Patient Name], a [Age]-year-old [Gender] patient, with no current breast complaints. Patient reports [Family history of breast cancer - Yes/No, and specify relationship if yes]. Menstrual history is [Menarche age, Menopausal status, LMP if applicable]. Patient denies any history of breast biopsies, surgeries, or prior abnormal mammograms. Patient is not currently taking any hormones. No palpable breast masses or skin changes noted on clinical breast exam. Mammogram images obtained in the standard craniocaudal and mediolateral oblique projections bilaterally. Breast composition is [Density - almost entirely fatty, scattered fibroglandular densities, heterogeneously dense, extremely dense]. No suspicious masses, architectural distortion, or microcalcifications identified. Lymph nodes are unremarkable. Impression: Negative screening mammogram - BIRADS 1. Recommend routine screening mammography in [Time interval - 1 year/2 years] based on current guidelines and individual risk factors. Patient counseled on the importance of regular breast self-exams and annual clinical breast exams. Patient understands the findings and recommendations.