77067

Clinical Indications

• Routine annual screening for breast cancer in asymptomatic women aged 40 and older, in accordance with national guidelines (e.g., American Cancer Society, American College of Radiology).
• Screening for women under 40 with a strong family history of breast cancer, genetic predisposition, or other significant risk factors, when clinically indicated.
• Follow-up screening in asymptomatic women with a personal history of certain benign breast conditions (e.g., atypical hyperplasia, lobular carcinoma in situ) that increase breast cancer risk.

Procedure Steps

1. Patient positioning for the craniocaudal (CC) view of the first breast.
2. Application of breast compression for optimal image quality and radiation dose reduction.
3. Acquisition of the X-ray image for the CC view.
4. Repositioning for the mediolateral oblique (MLO) view of the same breast.
5. Application of breast compression for the MLO view.
6. Acquisition of the X-ray image for the MLO view.
7. Repeat of CC and MLO views for the contralateral breast.
8. Digital image processing and reconstruction.
9. Radiologist interpretation of the mammographic images.
10. Application and review of Computer-Aided Detection (CAD) findings, if performed, to highlight potential areas of concern.
11. Generation of a comprehensive radiology report detailing findings and recommendations.

Coding Guidelines

• Code 77067 is specifically for *screening* mammography, performed on asymptomatic patients. Do not use for diagnostic mammography (e.g., for patients presenting with symptoms like a lump, pain, or nipple discharge) which should be coded with 77066 (bilateral diagnostic) or 77065 (unilateral diagnostic).
• This code inherently includes the performance of computer-aided detection (CAD) when utilized; do not report CAD separately with 77067.
• This code is for a *bilateral* study. If only one breast is screened, an appropriate unilateral diagnostic code or a screening code that allows for unilateral reporting (if available and clinically justified) should be used, though bilateral is standard for screening.
• Medicare covers screening mammography at specific intervals (e.g., annually for women 40 and over). Verify payer-specific guidelines for frequency and age restrictions.
• If a screening mammogram is performed and an abnormality is found that requires an immediate diagnostic mammogram on the same day, both a screening code and a diagnostic code (e.g., 77066-59) may be reported if both services are distinct and fully documented, following payer rules for modifiers.

Associated ICD-10 Codes

• Z12.31 - Encounter for screening mammogram for malignant neoplasm of breast
• Z80.3 - Family history of malignant neoplasm of breast
• Z15.01 - Genetic susceptibility to malignant neoplasm of breast
• Z87.890 - Personal history of other specified conditions