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ICD-10 Guide
ICD-10 CodesR92.1

R92.1

Mammographic calcification found on diagnostic imaging of breast

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/11/2025

Code Description

ICD-10 R92.1 is a billable code used to indicate a diagnosis of mammographic calcification found on diagnostic imaging of breast.

Key Diagnostic Point:

Mammographic calcifications are small deposits of calcium that can appear in breast tissue and are often detected during routine mammography. These calcifications can be classified as either benign or malignant based on their appearance and distribution. Benign calcifications may be associated with conditions such as fibrocystic changes, while suspicious calcifications may indicate the presence of breast cancer. The identification of calcifications on mammograms necessitates further evaluation, which may include additional imaging studies or biopsy to determine their nature. The presence of calcifications can be a critical finding in breast cancer screening and diagnosis, as they may serve as an early indicator of malignancy. Accurate coding of this finding is essential for appropriate patient management and treatment planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in calcification patterns and their interpretations
  • Need for correlation with clinical findings and patient history
  • Potential for overlap with other breast conditions
  • Documentation requirements for imaging results

Audit Risk Factors

  • Inadequate documentation of imaging findings
  • Failure to specify the type of calcification
  • Misinterpretation of benign versus malignant calcifications
  • Lack of follow-up documentation for further imaging or biopsy

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Documentation should include the reason for the mammogram, findings, and any follow-up recommendations.

Common Clinical Scenarios

Routine screening mammograms revealing calcifications, follow-up on previous findings.

Billing Considerations

Ensure that the clinical context is clear, especially if the patient has a history of breast disease.

Emergency Medicine

Documentation Requirements

Acute care documentation must include the patient's presenting symptoms and the urgency of the imaging.

Common Clinical Scenarios

Patients presenting with breast pain or palpable masses requiring immediate imaging.

Billing Considerations

Consider the need for expedited follow-up if suspicious calcifications are found.

Coding Guidelines

Inclusion Criteria

Use R92.1 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code is used only when calcifications are specifically identified on diagnostic imaging

Exclusion Criteria

Do NOT use R92.1 When
No specific exclusions found.

Related CPT Codes

77067CPT Code

Mammography, bilateral, including computer-aided detection

Clinical Scenario

Used when a mammogram is performed that reveals calcifications.

Documentation Requirements

Document the reason for the mammogram and findings.

Specialty Considerations

Ensure that the imaging report is available for coding.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of mammographic findings, improving the accuracy of breast cancer screening data and facilitating better patient management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of mammographic findings, improving the accuracy of breast cancer screening data and facilitating better patient management.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of mammographic findings, improving the accuracy of breast cancer screening data and facilitating better patient management.

Resources

Clinical References

  • •
    American College of Radiology - Breast Imaging

Coding & Billing References

  • •
    American College of Radiology - Breast Imaging

Frequently Asked Questions

What should be documented when coding R92.1?

Documentation should include the type of calcifications, their location, any associated symptoms, and recommendations for follow-up imaging or biopsy.