How To Use CPT Code 77066

CPT 77066 refers to a diagnostic mammography procedure performed on both breasts, which may include computer-aided detection (CAD) when performed. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 77066.

1. What is CPT 77066?

CPT 77066 is a medical billing code used to describe a diagnostic mammography procedure performed on both breasts, which may include the use of computer-aided detection (CAD) when performed. This code is used by medical coders and billers to accurately document and bill for this specific procedure.

2. 77066 CPT code description

The official description of CPT code 77066 is: “Diagnostic mammography, including computer-aided detection (CAD) when performed; bilateral.”

3. Procedure

  1. The patient is positioned for the mammography procedure.
  2. Each breast is placed between two plates, which are then pressed together firmly.
  3. The compressor has an X-ray plate that exposes the breast to radiation to obtain images.
  4. Computer-aided detection (CAD) software may be used to enhance the detection of abnormalities and improve the analysis of the images.
  5. The provider reviews the images, with any CAD-detected abnormalities marked for further evaluation.

4. Qualifying circumstances

Patients who are eligible to receive CPT 77066 services include those with a lump or suspected cancer in one or both breasts. This diagnostic procedure is performed to determine the type of disease and its causes, as well as to identify any abnormalities within the breast tissue.

5. When to use CPT code 77066

It is appropriate to bill the 77066 CPT code when a diagnostic mammography procedure is performed on both breasts, and computer-aided detection (CAD) is used when performed. This code should be used for diagnostic purposes, not for routine screening mammography.

6. Documentation requirements

To support a claim for CPT 77066, the following information should be documented:

  • Patient’s medical history and reason for the diagnostic mammography
  • Physical examination findings
  • Details of the mammography procedure, including the use of CAD when performed
  • Findings and interpretation of the mammography images
  • Any recommendations for further evaluation or treatment

7. Billing guidelines

When billing for CPT 77066, keep in mind the following guidelines and tips:

  • For the same procedure on a single breast, report CPT 77065.
  • For a bilateral procedure but two views from different angles, report CPT 77067.
  • If reporting only the physician’s interpretation for the radiology service, append professional component modifier 26 to the radiology code.
  • If reporting only the technical component for the radiology service, append modifier TC to the radiology code. 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.

8. Historical information

CPT 77066 was added to the Current Procedural Terminology system on January 1, 2017. There have been no updates to this code since its addition.

9. Similar codes to CPT 77066

Five similar codes to CPT 77066 and how they differentiate are:

  • CPT 77065: Diagnostic mammography performed on a single breast, including CAD when performed.
  • CPT 77067: Screening mammography, bilateral, including CAD when performed.
  • CPT 77063: Screening digital breast tomosynthesis, bilateral, used in conjunction with CPT 77067 for 3D imaging.
  • CPT 77061: Diagnostic digital breast tomosynthesis, unilateral, including CAD when performed.
  • CPT 77062: Diagnostic digital breast tomosynthesis, bilateral, including CAD when performed.

10. Examples

Here are 10 detailed examples of CPT code 77066 procedures:

  1. A 45-year-old female with a palpable lump in her left breast undergoes a diagnostic mammography with CAD on both breasts.
  2. A 50-year-old female with a family history of breast cancer presents with nipple discharge and undergoes a diagnostic mammography with CAD on both breasts.
  3. A 55-year-old female with a history of breast cancer in her right breast undergoes a diagnostic mammography with CAD on both breasts as part of her follow-up care.
  4. A 60-year-old female with breast pain and skin changes on her left breast undergoes a diagnostic mammography with CAD on both breasts.
  5. A 65-year-old female with a suspicious finding on a recent screening mammogram undergoes a diagnostic mammography with CAD on both breasts for further evaluation.
  6. A 70-year-old female with a history of breast cancer in her left breast and a new palpable lump in her right breast undergoes a diagnostic mammography with CAD on both breasts.
  7. A 75-year-old female with a history of breast cancer in her right breast and a suspicious finding on a recent screening mammogram undergoes a diagnostic mammography with CAD on both breasts for further evaluation.
  8. A 40-year-old female with a strong family history of breast cancer and a BRCA gene mutation undergoes a diagnostic mammography with CAD on both breasts as part of her high-risk screening protocol.
  9. A 48-year-old female with a history of breast cancer in her left breast and a new palpable lump in her left breast undergoes a diagnostic mammography with CAD on both breasts.
  10. A 52-year-old female with a history of breast cancer in her right breast and a suspicious finding on a recent screening mammogram undergoes a diagnostic mammography with CAD on both breasts for further evaluation.

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