NCCI Edit Manual Revised in 2016 to Allow Billing Mammography Post Breast Intervention Performed with Stereotactic Guidance

The 2016 National Correct Coding Initiative (NCCI) Manual for Medicare Services had a revision that may be overlooked, as it involved removal of text. We are publishing errata for our reference manuals, as we did not note it until the manuals were already printed.

The 2016 instruction in Chapter 3 is amended as noted below:

6. If a breast biopsy, needle localization wire, metallic localization clip, or other breast procedure is performed with mammographic or stereotactic guidance (e.g., 19081-19082, 19281,19282), the physician should not separately report a post procedure mammography code (e.g., 77051, 77052, 77055-77057, G0202-G0206) for the same patient encounter. The radiologic guidance codes include all imaging by the defined modality required to perform the procedure. 

The guideline stating that the post procedure mammogram is bundled into a stereotactic guided procedure has been removed. The post procedure mammogram is only bundled into a mammographic guided intervention.