77067

Screening Mammography, Bilateral, including CAD

Screening mammography is a radiological examination of the breasts performed on asymptomatic individuals to detect unsuspected breast cancer. This code specifically applies to bilateral studies and includes computer-aided detection (CAD) when utilized as part of the screening process.

Clinical Indications

  • Routine annual screening for breast cancer in women aged 40 and older, as recommended by various medical guidelines.
  • Screening for women with increased risk factors for breast cancer but who are asymptomatic.
  • Follow-up screening in women with a history of treated breast cancer, without current signs of recurrence.

Procedure Steps

  1. Patient positioning: The technologist positions each breast on a specialized platform.
  2. Compression: The breast is compressed to flatten the tissue, reduce radiation dose, and improve image quality.
  3. Image acquisition: X-rays are taken from at least two different angles (e.g., craniocaudal (CC) and mediolateral oblique (MLO)) for each breast.
  4. Image processing: Digital images are processed and reviewed by a radiologist.
  5. Computer-aided detection (CAD): If used, software analyzes the images for suspicious areas, highlighting them for the radiologist's attention.
  6. Interpretation: A radiologist interprets the images, looking for masses, calcifications, architectural distortions, or other signs of abnormalities.
  7. Reporting: A final report is generated and communicated to the referring physician and patient.

Coding Guidelines

  • CPT 77067 is used for screening mammography only, performed on asymptomatic patients. For diagnostic mammography (e.g., due to symptoms or abnormal screening results), use CPT codes 77065 (unilateral) or 77066 (bilateral).
  • This code inherently includes CAD (Computer-Aided Detection) if performed. Do not report separate CAD codes (e.g., 77084) in conjunction with 77067.
  • Bilateral mammography means both breasts are imaged. If only one breast is screened, CPT 77067 is not appropriate.
  • Frequency of screening mammography is typically once per year, though this can vary based on patient risk factors and specific guideline recommendations.
  • Ensure appropriate ICD-10-CM codes are linked to reflect the reason for screening (e.g., routine screening, high risk).

Associated ICD-10 Codes