Does CPT code 76641 need a modifier?
Table of Contents
Does CPT code 76641 need a modifier?
CPT codes 76641 (ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete) and 76642 (… limited) are reimbursable for the diagnostic evaluation of the breast. These codes are split-billable and must be billed with modifiers 26 and TC.
What is the diagnosis code for screening mammogram?
Group 1
| Code | Description |
|---|---|
| Z12.31 | Encounter for screening mammogram for malignant neoplasm of breast |
How do you bill bilateral breast ultrasound?
Report 76641 or 76442 once, per breast, per session. Both codes are unilateral: If medical necessity requires bilateral imaging, you may append modifier 50 Bilateral procedure.
Is CPT 76641 bilateral?
BREAST SONOGRAPHY If performed bilaterally, a modifier 50 may be reported with CPT code 76641 or 76642.
What is the CPT code for screening breast ultrasound?
Per the CPT® 2021 codebook, Professional Edition, p. 536, code 76641 represents a complete ultrasound examination of the breast.
What is the CPT code for ultrasound breast bilateral?
There is a new note in the CPT® Manual that directs the assignment of the limited extremity code 76882 if only the axilla is evaluated using ultrasound….
| Code | Description |
|---|---|
| 77062 | … bilateral |
| +77063 | Screening digital breast tomosynthesis, bilateral (list separately in addition to code for primary procedure) |
When do we use GG modifier?
HCPCS modifier GG is used to report performance and payment of a screening mammography and diagnostic mammography on the same patient on the same day. Medicare allows additional mammogram films to be performed without an additional order from the treating physician.
Does CPT code 77067 need a modifier?
Because the CPT code descriptor for 77067 and G0202 state “bilateral,” it would be appropriate to use a 52 modifier (reduced level of service) to designate a screening procedure of only one breast.
What is the CPT code for a mammogram?
| Test | CPT Code |
|---|---|
| 2D Mammogram (screening) | 77067 (both breasts, 2-views of each) |
| 2D Mammogram (diagnostic) | 77065 (one breast) 77066 (both breasts) |
| 3D Mammogram /tomosynthesis (screening) | 77067 (2D both breasts) + 77063 (3D both breasts ) |
What modifier is used when reporting a breast procedure done on both breasts?
One structure, two sides, calls for modifier 50 For example, removal of malignant breast tissue may be performed on one breast (unilaterally), or on both breasts (bilaterally). You may append modifier 50 only to those codes not already defined as bilateral by a specific CPT® code.
What is a US thyroid ultrasound?
Thyroid ultrasound uses sound waves to produce pictures of the thyroid gland within the neck. It does not use ionizing radiation and is commonly used to evaluate lumps or nodules found during a routine physical or other imaging exam. This procedure requires little to no special preparation.
What does GG modifier stand for?
HCPCS modifier GG is used to report performance and payment of a screening mammography and diagnostic mammography on the same patient on the same day. Guidelines and Instructions. Medicare allows additional mammogram films to be performed without an additional order from the treating physician.
