October is Breast Cancer Awareness month and it’s a great time to review codes for breast imaging.

Mammography

The Centers for Medicare & Medicaid Services (CMS) recognizes CPT® mammography codes. For mammography screenings, use the codes in the tables below. Just as a reminder:

  • Mammography screenings are performed for a person without symptoms or signs of breast cancer
  • Diagnostic mammography screenings are performed for a person with symptoms or signs of breast cancer, a personal history, or a previous biopsy.

Screening Breast Tomosynthesis (Bilateral) – 

CPT® and/or HCPCS CodesDescription
77067Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed
+77063Screening digital breast tomosynthesis, bilateral (List separately in addition to code for primary procedure)

Diagnostic Breast Tomosynthesis (Unilateral) – 

CPT® and/or HCPCS CodesDescription
77065Diagnostic Mammography, including computer-aided detection (CAD) when performed; unilateral
+G0279Diagnostic digital breast tomosynthesis, unilateral or bilateral (List separately in addition to 77065 or 77066)

Diagnostic Breast Tomosynthesis (Bilateral) – 

CPT® and/or HCPCS CodesDescription
77066Diagnostic Mammography, including computer-aided detection (CAD) when performed; bilateral
+G0279Diagnostic digital breast tomosynthesis, unilateral or bilateral (List separately in addition to 77065 or 77066)

Breast Ultrasonography

When a mammography reveals an abnormal finding, a breast ultrasound may be used during a needle biopsy or as a follow-up test. Just as a reminder – modifiers that can be used for the codes in the table below are:

  • 50 – Bilateral procedure
  • 26- Professional component
  • TC – Technical component
CPT® CodesDescription
76641Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete
76642Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited

Elastography – 

CPT® CodesDescription
76981Ultrasound, elastography, parenchyma
76982Ultrasound, elastography; first target lesion
+76983Ultrasound, elastography; each additional target lesion (List separately in addition to code for primary procedure)