A: The coding for a mammogram following a vacuum-assisted, image-guided breast biopsy and tissue marker placement would depend on the modality used, as well as the number of physicians involved. The biopsy is appropriately coded 19103 for the percutaneous vacuum-assisted breast biopsy using imaging guidance, 76095 for the stereotactic localization, and 19125 for the placement of the tissue marker.
If all of the imaging takes place on a stereotactic machine and is performed by the same physician, the post-procedure mammogram is included in code 76095. Code 76095 includes all of the imaging and work involved by a physician to perform this procedure. Therefore, it is not appropriate to code for the follow-up mammogram.
There are instances, however, when it would be appropriate to code separately for a mammogram post vacuum-assisted breast biopsy. The rationale for this is that the mammogram is a separate procedure using a different imaging modality and it is not essential to the successful completion of the ultrasound guidance procedure.
Another instance when it would be appropriate to code separately for the follow-up mammogram is when a surgeon does the stereotactic procedure and clip placement, and then refers the patient to radiology for a follow-up mammogram or ultrasound. In this instance, it is appropriate for the radiologist to code for the mammogram or ultrasound study performed. This is one of many examples where coding is dependent on whether there is one or multiple physicians involved in the steps of the procedure