Summary & Overview
HCPCS G9900: Mammography Results Not Documented and Reviewed
HCPCS Level II code G9900 identifies instances when screening or diagnostic mammography—including film, digital, or digital breast tomosynthesis (3D)—had results that were not documented and reviewed, with the reason listed as not otherwise specified. Nationally, this code signals gaps in documentation workflows for breast imaging and can affect quality reporting, tracking of follow-up care, and administrative reconciliation across providers and payers. Key payers in this review include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. This publication provides a concise overview of the code’s clinical and administrative context, outlines where the service is typically performed (imaging centers and outpatient radiology departments), and summarizes what readers will learn: benchmarks and prevalence indicators where available, implications for quality measurement and billing accuracy, and policy or payer guidance relevant to documentation of mammography results. The report highlights common modifiers and coding considerations provided in the input and notes when supporting data are not available. It is intended for national audiences of billing professionals, radiology administrators, and payer policy analysts seeking a clear statement of the code’s meaning, operational impact, and areas where documentation processes commonly fail.
Billing Code Overview
HCPCS Level II code G9900 denotes that screening, diagnostic, film, digital or digital breast tomosynthesis (3D) mammography results were not documented and reviewed, with the reason marked as not otherwise specified. The service type is mammography result documentation/review. The typical site of service is imaging centers or outpatient radiology departments where screening or diagnostic mammography and digital breast tomosynthesis are performed.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 58-year-old woman presents to an outpatient breast imaging center for routine screening mammography using digital breast tomosynthesis (3D mammography). The technologist completes image acquisition, but during post-procedure charting the mammography results were not documented in the electronic medical record and were not reviewed by the interpreting radiologist due to an unexpected workflow interruption (for example, a system outage or immediate clinical diversion). The facility documents that the screening/exam was performed but the formal interpretation and final report are absent. Typical workflow: patient registration → image acquisition (screening or diagnostic mammography, often digital or digital breast tomosynthesis) → image transfer to PACS → radiologist review and final report → results communicated to ordering clinician and patient. Use of billing code G9900 indicates the mammography images exist but interpretation/documentation of results was not completed or recorded, with reason not otherwise specified.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 |