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 Action
Alerts
New Radiology Screening Codes in 2007
January 2007
Mammography Codes
There are several CPT coding changes in the Radiology Chapter of the 2007 CPT
Coding Book. The following table describes the mammography HCPCS codes, which
must be submitted on a claim for service dates after January 1, 2007.
2007 Screening and Diagnostic Mammography CPT Codes
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2007 Codes
|
Description
|
| +77051* |
Computer aided detection (computer algorithm analysis of digital image data for
lesion detection) with further physician review for interpretation with or
without digitalization of film radiographic images, diagnostic mammography |
| +77052* |
Computer aided detection (computer algorithm analysis of digital image data for
lesion detection) with further physician review for interpretation with or
without digitalization of film radiographic images, screening mammography |
| 77055* |
Diagnostic mammography, unilateral |
| 77056* |
Diagnostic mammography, bilateral |
| 77057* |
Screening mammography, bilateral (two view film study of each breast) |
| G0202 |
Screening mammography, producing direct digital image, bilateral, all views |
| G0204 |
Diagnostic mammography, producing direct digital image, bilateral, all views |
| G0206 |
Diagnostic mammography, producing direct digital image, unilateral, all views |
*New in 2007
Abdominal Aortic Aneurysm (AAA) Screening
HCPCS code G0389 (ultrasound, B-scan/real time with image documentation, for
AAA screening) is a new code added in 2007. This new screening benefit CMS
added is effective January 1, 2007. There are some restrictions and
limitations, which must be met in order for this preventive code to be paid by
the fiscal intermediary. The patient must meet the following criteria:
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Receive a referral for the ultrasound screening benefit as a result of an
initial preventive physician exam (IPPE). (The IPPE is a once-a-lifetime
benefit and must be performed within 6 months after the effective date of the
beneficiary’s first Part B coverage on or after January 1, 2005.)
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Receive the screening from an authorized provider/supplier of ultrasound
diagnostic services.
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Not have received an ultrasound screening for AAA under the Medicare program.
In addition, the patient must have at least one of the following risk factors:
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Have a family history of abdominal aortic aneurysms
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Be a man aged 65 to 75 years who has smoked at least 100 cigarettes in his
lifetime
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Be a beneficiary who manifests other risk factors in a beneficiary category
recommended for screening by the United States Preventive Services Task Force
regarding AAA, as specified by the Secretary of Health and Human Services’
national coverage determination process.
If a provider cannot determine whether or not the patient has had a previous
aneurysm screening or if there is a question of medical necessity, an advanced
beneficiary notice (ABN) should be issued to the patient.
Be sure your hospital’s charge description master (CDM) is current with these
screening codes for 2007.
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