Ask Dr. Z

Can you please provide clarification on the following guidance regarding billing for post-biopsy mammograms? According to the ACR’s Committee on Coding and Nomenclature it is appropriate to code for a unilateral diagnostic mammogram (77065) for verification of clip placement after biopsy when it is performed on separate pieces of equipment, if it is a different modality from the primary procedure, or if separate physicians are involved. Is the ACR directive intended to be interpreted as three separate qualifying circumstances? (1) On a separate piece of equipment, OR (2) it’s a different modality, OR (3) separate physicians are involved. If any of the qualifying conditions exists, then the post-biopsy mammogram can be separately billed?