Breast tomosynthesis, also known as 3D mammography, is an advanced imaging technology used to detect breast cancer. Accurate coding for breast tomosynthesis is essential to ensure proper reimbursement for the procedure. The following are some coding tips for CPT codes for breast tomosynthesis:
- Know the codes: The CPT codes for breast tomosynthesis are 77063 for unilateral breast tomosynthesis and 77064 for bilateral breast tomosynthesis.
- Use the appropriate modifier: If a diagnostic mammogram and breast tomosynthesis are performed on the same day, report the mammogram code (77065, 77066, or 77067) with modifier -GG (performance and payment of a diagnostic mammogram and tomosynthesis on the same day).
- Understand coding guidelines: The American College of Radiology (ACR) has specific guidelines for reporting breast tomosynthesis codes, which may include documentation of the number of images obtained, the number of masses or distortions identified, and the number of benign and malignant lesions detected.
- Document the details: Accurate and detailed documentation is essential for proper coding and billing. Documentation should include the number of images obtained, the number of masses or distortions identified, and the number of benign and malignant lesions detected.
- Verify coverage: Before performing breast tomosynthesis, it is essential to verify the coverage and reimbursement policies of the patient’s insurance plan and ensure that the codes selected are supported by the medical documentation.
- Stay up-to-date: Keep up-to-date with changes to coding guidelines and requirements to ensure accurate and timely billing and reimbursement.
In summary, accurate coding for breast tomosynthesis requires an understanding of the appropriate codes, modifiers, and documentation requirements. Following the ACR guidelines and verifying coverage and reimbursement policies can help ensure timely and accurate billing and reimbursement for the procedure.