Ask Dr. Z

Please do NOT include any actual patient medical records with your question. We have some confusion on how to charge for mammograms on patients where one breast is asymptomatic and the other breast is symptomatic. If physician orders a unilateral diagnostic mammogram and unilateral screening mammogram because a patient has symptoms in one breast and it is also time for the other breast to be screened should change the order to a bilateral diagnostic exam? I have always been under the impression if one breast is asymptomatic that the exam automatically becomes a diagnostic bilateral exam to compare breast tissue. Also, if a patient has had prior unilateral diagnostic exams for an area that is being watched or a past biopsy and that breast is due for a six month followup unilateral diagostic exam but, it is also time for a screening exam on the other breast can we then charge for unilateral screening mammogram and a unilateral diagnostic mammogram or should that also be a bilateral diagnostic exam? Thank you for your advice! Sorry if the