How To Use CPT Code 77062

CPT 77062 refers to the diagnostic digital breast tomosynthesis procedure performed on both breasts. This article will cover topics such as the description, procedure, qualifying circumstances, when to use the code, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 77062 procedures.

1. What is CPT 77062?

CPT 77062 is a medical billing code used to describe the diagnostic digital breast tomosynthesis procedure performed on both breasts. This procedure is used to obtain clear three-dimensional images of breast tissue for diagnostic purposes, helping healthcare providers detect and diagnose breast abnormalities, such as cancer or other conditions.

2. 77062 CPT code description

The official description of CPT code 77062 is: “Diagnostic digital breast tomosynthesis; bilateral.”

3. Procedure

The 77062 procedure involves the following steps:

  1. The patient is appropriately prepped for the procedure.
  2. The provider confines and compresses the breast between a platform and paddle.
  3. The X-ray tube moves in an arc around the breast, taking images during an examination time of approximately seven seconds.
  4. The images appear on the computer as clear three-dimensional images of the breast for analysis and interpretation.
  5. The provider repeats the same procedure on the second breast.

4. Qualifying circumstances

Patients eligible to receive CPT code 77062 services are those who require diagnostic digital breast tomosynthesis for both breasts. This may include patients with a history of breast cancer, those with suspicious findings on a screening mammogram, or those with breast symptoms such as pain, lump, or nipple discharge. The healthcare provider will determine if the patient meets the criteria for this procedure based on their medical history, physical examination, and other relevant factors.

5. When to use CPT code 77062

It is appropriate to bill the 77062 CPT code when a healthcare provider performs diagnostic digital breast tomosynthesis on both breasts for diagnostic purposes. This code should be used when the procedure is performed to evaluate breast abnormalities, such as cancer or other conditions, and not for routine screening purposes.

6. Documentation requirements

To support a claim for CPT 77062, the following information should be documented:

  • Patient’s medical history and physical examination findings
  • Indication for the procedure (e.g., breast symptoms, suspicious findings on a screening mammogram, or history of breast cancer)
  • Details of the procedure, including the equipment used, images obtained, and any complications encountered
  • Provider’s interpretation of the images and any recommendations for further evaluation or treatment

7. Billing guidelines

When billing for CPT code 77062, it is essential to follow the appropriate guidelines and rules. Some tips and codes that apply to this procedure include:

  • Use CPT code 77061 for digital breast tomosynthesis performed on one breast.
  • For a screening service, use CPT code +77063.
  • Append professional component modifier 26 to the radiology code when reporting only the physician’s interpretation for the radiology service.
  • Append modifier TC to the radiology code when reporting only the technical component for the radiology service. Note that payer policy may exempt hospitals from appending modifier TC because the hospital’s portion is inherently technical.
  • Do not append a professional or technical modifier to the radiology code when reporting a global service in which one provider renders both the professional and technical components.
  • Do not report CPT codes 77061, 77062 in conjunction with 76376, 76377, or 77067.

8. Historical information

CPT 77062 was added to the Current Procedural Terminology system on January 1, 2015. The code was changed on January 1, 2019, with the previous descriptor being “Digital breast tomosynthesis; bilateral.”

9. Similar codes to CPT 77062

Five similar codes to CPT 77062 and how they differentiate from it are:

  1. CPT 77061: This code is used for digital breast tomosynthesis performed on one breast, as opposed to both breasts in CPT 77062.
  2. +77063: This code is used for screening digital breast tomosynthesis, whereas CPT 77062 is used for diagnostic purposes.
  3. 76376: This code is for 3D rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, or other tomographic modality, which is different from the digital breast tomosynthesis procedure in CPT 77062.
  4. 76377: This code is for 3D rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, or other tomographic modality with post-processing on an independent workstation, which is different from the digital breast tomosynthesis procedure in CPT 77062.
  5. 77067: This code is for screening mammography, bilateral, which is a different procedure from the diagnostic digital breast tomosynthesis in CPT 77062.

10. Examples

Here are 10 detailed examples of CPT code 77062 procedures:

  1. A patient with a history of breast cancer presents with new breast pain and requires diagnostic digital breast tomosynthesis of both breasts.
  2. A patient with a suspicious finding on a screening mammogram undergoes diagnostic digital breast tomosynthesis of both breasts for further evaluation.
  3. A patient with a palpable breast lump undergoes diagnostic digital breast tomosynthesis of both breasts to assess for possible malignancy.
  4. A patient with nipple discharge undergoes diagnostic digital breast tomosynthesis of both breasts to evaluate for underlying breast abnormalities.
  5. A patient with a strong family history of breast cancer undergoes diagnostic digital breast tomosynthesis of both breasts due to concerns about breast cancer risk.
  6. A patient with a history of breast implants undergoes diagnostic digital breast tomosynthesis of both breasts to evaluate for possible implant rupture or complications.
  7. A patient with a history of breast radiation therapy undergoes diagnostic digital breast tomosynthesis of both breasts to monitor for potential radiation-induced changes.
  8. A patient with dense breast tissue undergoes diagnostic digital breast tomosynthesis of both breasts to evaluate for possible hidden breast abnormalities.
  9. A patient with a history of atypical ductal hyperplasia undergoes diagnostic digital breast tomosynthesis of both breasts to monitor for potential development of breast cancer.
  10. A patient with a history of breast biopsy for benign findings undergoes diagnostic digital breast tomosynthesis of both breasts to monitor for any changes in breast tissue.

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