Medical billing hodge podge thread.

dietz199
Sun, 08 May 2016 06:51:31 +0000

Not medicare related…

I went for my annual mammogram. CA mandates a patient be told if they have dense breast tissue. Dense breast tissue can hide certain problems. A followup SCREENING ultrasound mammogram is suggested.

After being told by the provider that it was covered by insurance under the ‘screening’ category I received a bill for the full amount.

I fought this for 6 months - and I have a great track record of winning these fights. Not this time. The end result… there is no CPT code which allows for a screening ultra sound mammogram. They are ALL diagnostic. The diagnosis is ‘dense breast tissue’. Dense breast tissue is a completely normal condition, it is a by product for some of us because we …um…have breasts. That’s the story I was given…and they are sticking too it.

This story is to be continued on an annual basis I guess until it become a big enough issue that this particular infinite loop gets untangled.

Until then I will only go for the ultra sound every two years.