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Scintimammography/Breast-Specific Gamma Imaging/Molecular Breast Imaging

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Scintimammography/Breast-Specific Gamma Imaging/Molecular Breast Imaging Medical Policy Scintimammography/Breast-Specific Gamma Imaging/Molecular Breast Imaging Table of Contents Policy: Commercial Coding Information Information Pertaining to All Policies Policy: Medicare Description References Authorization Information Policy History Policy Number: 494 BCBSA Reference Number: 6.01.18 Related Policies MRI of the Breast, #230 Oncologic Applications of PET Scanning, #229 Policy Commercial Members: Managed Care (HMO and POS), PPO, and Indemnity Medicare HMO BlueSM and Medicare PPO BlueSM Members Scintimammography, breast-specific gamma imaging (BSGI), and molecular breast imaging (MBI) are INVESTIGATIONAL in all applications, including, but not limited to their use as an adjunct to mammography or in staging the axillary lymph nodes. Preoperative or intraoperative sentinel lymph node detection using handheld or mounted mobile gamma cameras is INVESTIGATIONAL. Prior Authorization Information Pre-service approval is required for all inpatient services for all products. See below for situations where prior authorization may be required or may not be required for outpatient services. Yes indicates that prior authorization is required. No indicates that prior authorization is not required. Outpatient Inpatient Commercial Managed Care (HMO This is not a covered service. This is not a covered service. and POS) Commercial PPO and Indemnity This is not a covered service. This is not a covered service. Medicare HMO BlueSM This is not a covered service. This is not a covered service. Medicare PPO BlueSM This is not a covered service. This is not a covered service. 1 CPT Codes / HCPCS Codes / ICD-9 Codes The following codes are included below for informational purposes. Inclusion or exclusion of a code does not constitute or imply member coverage or provider reimbursement. Please refer to the member’s contract benefits in effect at the time of service to determine coverage or non-coverage as it applies to an individual member. A draft of future ICD-10 Coding related to this document, as it might look today, is included below for your reference. Providers should report all services using the most up-to-date industry-standard procedure, revenue, and diagnosis codes, including modifiers where applicable. CPT Codes CPT codes: Code Description 78800 Radiopharmaceutical localization of tumor or distribution of radiopharmaceutical agent(s); limited area 78801 Radiopharmaceutical localization of tumor or distribution of radiopharmaceutical agent(s); multiple areas HCPCS Codes HCPCS codes: Code Description A9500 Technetium tc-99m sestamibi, diagnostic, per study dose S8080 Scintimammography (radioimmunoscintigraphy of the breast), unilateral, including supply of radiopharmaceutical ICD-9 Diagnosis Codes ICD-9 Diagnosis codes: Code Description 174.0 Malignant neoplasm of nipple and areola of female breast 174.1 Malignant neoplasm of central portion of female breast 174.2 Malignant neoplasm of upper-inner quadrant of female breast 174.3 Malignant neoplasm of lower-inner quadrant of female breast 174.4 Malignant neoplasm of upper-outer quadrant of female breast 174.5 Malignant neoplasm of lower-outer quadrant of female breast 174.6 Malignant neoplasm of axillary tail of female breast 174.8 Malignant neoplasm of other specified sites of female breast 174.9 Malignant neoplasm of breast (female), unspecified 175.0 Malignant neoplasm of nipple and areola of male breast 175.9 Malignant neoplasm of other and unspecified sites of male breast Secondary and unspecified malignant neoplasm of lymph nodes of axilla and upper 196.3 limb 198.81 Secondary malignant neoplasm of breast 217 Benign neoplasm of breast 233.0 Carcinoma in situ of breast 793.80 Abnormal mammogram, unspecified 793.81 Mammographic microcalcification 793.82 Inconclusive mammogram 793.89 Other (abnormal) findings on radiological examination of breast ICD-10 Diagnosis Codes ICD-10-CM Diagnosis codes: Code Description 2 C50.011 Malignant neoplasm of nipple and areola, right female breast C50.012 Malignant neoplasm of nipple and areola, left female breast C50.019 Malignant neoplasm of nipple and areola, unspecified female breast C50.021 Malignant neoplasm of nipple and areola, right male breast C50.022 Malignant neoplasm of nipple and areola, left male breast C50.029 Malignant neoplasm of nipple and areola, unspecified male breast C50.111 Malignant neoplasm of central portion of right female breast C50.112 Malignant neoplasm of central portion of left female breast C50.119 Malignant neoplasm of central portion of unspecified female breast C50.121 Malignant neoplasm of central portion of right male breast C50.122 Malignant neoplasm of central portion of left male breast C50.129 Malignant neoplasm of central portion of unspecified male breast C50.211 Malignant neoplasm of upper-inner quadrant of right female breast C50.212 Malignant neoplasm of upper-inner quadrant of left female breast C50.219 Malignant neoplasm of upper-inner quadrant of unspecified female breast C50.221 Malignant neoplasm of upper-inner quadrant of right male breast C50.222 Malignant neoplasm of upper-inner quadrant of left male breast C50.229 Malignant neoplasm of upper-inner quadrant of unspecified male breast C50.311 Malignant neoplasm of lower-inner quadrant of right female breast C50.312 Malignant neoplasm of lower-inner quadrant of left female breast C50.319 Malignant neoplasm of lower-inner quadrant of unspecified female breast C50.321 Malignant neoplasm of lower-inner quadrant of right male breast C50.322 Malignant neoplasm of lower-inner quadrant of left male breast C50.329 Malignant neoplasm of lower-inner quadrant of unspecified male breast C50.411 Malignant neoplasm of upper-outer quadrant of right female breast C50.412 Malignant neoplasm of upper-outer quadrant of left female breast C50.419 Malignant neoplasm of upper-outer quadrant of unspecified female breast C50.421 Malignant neoplasm of upper-outer quadrant of right male breast C50.422 Malignant neoplasm of upper-outer quadrant of left male breast C50.429 Malignant neoplasm of upper-outer quadrant of unspecified male breast C50.511 Malignant neoplasm of lower-outer quadrant of right female breast C50.512 Malignant neoplasm of lower-outer quadrant of left female breast C50.519 Malignant neoplasm of lower-outer quadrant of unspecified female breast C50.521 Malignant neoplasm of lower-outer quadrant of right male breast C50.522 Malignant neoplasm of lower-outer quadrant of left male breast C50.529 Malignant neoplasm of lower-outer quadrant of unspecified male breast C50.611 Malignant neoplasm of axillary tail of right female breast C50.612 Malignant neoplasm of axillary tail of left female breast C50.619 Malignant neoplasm of axillary tail of unspecified female breast C50.621 Malignant neoplasm of axillary tail of right male breast C50.622 Malignant neoplasm of axillary tail of left male breast C50.629 Malignant neoplasm of axillary tail of unspecified male breast C50.811 Malignant neoplasm of overlapping sites of right female breast C50.812 Malignant neoplasm of overlapping sites of left female breast C50.819 Malignant neoplasm of overlapping sites of unspecified female breast C50.821 Malignant neoplasm of overlapping sites of right male breast C50.822 Malignant neoplasm of overlapping sites of left male breast C50.829 Malignant neoplasm of overlapping sites of unspecified male breast C50.911 Malignant neoplasm of unspecified site of right female breast C50.912 Malignant neoplasm of unspecified site of left female breast C50.919 Malignant neoplasm of unspecified site of unspecified female breast 3 C50.921 Malignant neoplasm of unspecified site of right male breast C50.922 Malignant neoplasm of unspecified site of left male breast C50.929 Malignant neoplasm of unspecified site of unspecified male breast C77.3 Secondary and unspecified malignant neoplasm of axilla and upper limb lymph nodes C79.81 Secondary malignant neoplasm of breast D05.00 Lobular carcinoma in situ of unspecified breast D05.01 Lobular carcinoma in situ of right breast D05.02 Lobular carcinoma in situ of left breast D05.10 Intraductal carcinoma in situ of unspecified breast D05.11 Intraductal carcinoma in situ of right breast D05.12 Intraductal carcinoma in situ of left breast D05.80 Other specified type of carcinoma in situ of unspecified breast D05.81 Other specified type of carcinoma in situ of right breast D05.82 Other specified type of carcinoma in situ of left breast D05.90 Unspecified type of carcinoma in situ of unspecified breast D05.91 Unspecified type of carcinoma in situ of right breast D05.92 Unspecified type of carcinoma in situ of left breast D24.1 Benign neoplasm of right breast D24.2 Benign neoplasm of left breast D24.9 Benign neoplasm of unspecified breast R92.0 Mammographic microcalcification found on diagnostic imaging of breast R92.1 Mammographic calcification found on diagnostic imaging of breast R92.2 Inconclusive mammogram R92.8 Other abnormal and inconclusive findings on diagnostic imaging of breast Description Scintimammography refers to the use of radiotracers with nuclear medicine imaging as a diagnostic tool for abnormalities of the breast. Breast-specific gamma imaging (BSGI), or molecular breast imaging (MBI), refers to specific types of imaging machines that are used in conjunction with scintimammography to improve diagnostic performance. Scintimammography is a diagnostic modality using radiopharmaceuticals to detect tumors of the breast. After intravenous injection of a radiopharmaceutical, the breast is evaluated using
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