Only one CPT code can be used for screening mammograms but it is often used in combination with the CPT codes for diagnostic mammograms after there is a suspicion of breast cancer after finding during the screening mammogram. We have also included the HCPCS codes that are relevant to Screening Mammograms.
1. CPT Code for Screening Mammogram
There is only one CPT code for Screening mammogram which is CPT code 77067.
Lay-term: CPT code 77067 is used when a provider performs a screening mammogram on both breasts, which may also include computer-aided detection.
Long description: Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed.
Short description: Bilateral screening mammogram with CAD.
2. CPT Codes for Diagnostic Mammogram
Diagnostic mammograms are performed when there is a suspicion of breast cancer due to symptoms or findings on a screening mammogram. The CPT codes for diagnostic mammograms are used to report these services.
2.1 CPT Code 77065
Lay-term: CPT code 77065 is used when a provider performs a diagnostic mammogram on one breast, which may also include computer-aided detection.
Long description: Diagnostic mammography, including computer-aided detection (CAD) when performed, unilateral.
Short description: Unilateral diagnostic mammogram with CAD.
2.2 CPT Code 77066
Lay-term: CPT code 77066 is used when a provider performs a diagnostic mammogram on both breasts, which may also include computer-aided detection.
Long description: Diagnostic mammography, including computer-aided detection (CAD) when performed, bilateral.
Short description: Bilateral diagnostic mammogram with CAD.
3. CPT Codes for Mammogram Assessment Categories
Mammogram assessment categories are used to classify the results of a mammogram. The CPT codes for mammogram assessment categories are used to report these results.
3.1 CPT Code 3014F
Lay-term: CPT code 3014F is used when the results of a screening mammogram are documented and reviewed.
Long description: Screening mammography results documented and reviewed.
Short description: Screening mammogram results reviewed.
3.2 CPT Code 3340F
Lay-term: CPT code 3340F is used when the mammogram assessment category is documented as “incomplete: need additional imaging evaluation”.
Long description: Mammogram assessment category of “incomplete: need additional imaging evaluation” documented.
Short description: Mammogram assessment: incomplete, needs more evaluation.
3.3 CPT Code 3341F
Lay-term: CPT code 3341F is used when the mammogram assessment category is documented as “negative”.
Long description: Mammogram assessment category of “negative,” documented.
Short description: Mammogram assessment: negative.
3.4 CPT Code 3342F
Lay-term: CPT code 3342F is used when the mammogram assessment category is documented as “benign”.
Long description: Mammogram assessment category of “benign,” documented.
Short description: Mammogram assessment: benign.
3.5 CPT Code 3343F
Lay-term: CPT code 3343F is used when the mammogram assessment category is documented as “probably benign”.
Long description: Mammogram assessment category of “probably benign,” documented.
Short description: Mammogram assessment: probably benign.
3.6 CPT Code 3344F
Lay-term: CPT code 3344F is used when the mammogram assessment category is documented as “suspicious”.
Long description: Mammogram assessment category of “suspicious,” documented.
Short description: Mammogram assessment: suspicious.
3.7 CPT Code 3345F
Lay-term: CPT code 3345F is used when the mammogram assessment category is documented as “highly suggestive of malignancy”.
Long description: Mammogram assessment category of “highly suggestive of malignancy,” documented.
Short description: Mammogram assessment: highly suggestive of malignancy.
3.8 CPT Code 3350F
Lay-term: CPT code 3350F is used when the mammogram assessment category is documented as “known biopsy proven malignancy”.
Long description: Mammogram assessment category of “known biopsy proven malignancy,” documented.
Short description: Mammogram assessment: known malignancy.
3.9 CPT Code 5060F
Lay-term: CPT code 5060F is used when the findings from a diagnostic mammogram are communicated to the practice managing the patient’s ongoing care within 3 business days of exam interpretation.
Long description: Findings from diagnostic mammogram communicated to practice managing patient’s on-going care within 3 business days of exam interpretation.
Short description: Mammogram findings communicated within 3 days.
3.10 CPT Code 5062F
Lay-term: CPT code 5062F is used when the findings from a diagnostic mammogram are communicated to the patient within 5 days of exam interpretation.
Long description: Findings from diagnostic mammogram communicated to the patient within 5 days of exam interpretation.
Short description: Mammogram findings communicated to patient within 5 days.
3.11 CPT Code 7020F
Lay-term: CPT code 7020F is used when the mammogram assessment category is documented.
Long description: Mammogram assessment category (e.g., Mammography Quality Standards Act MQSA, Breast Imaging Reporting and Data System BI-RADS).
Short description: Mammogram assessment category documented.
3.12 CPT Code 7025F
Lay-term: CPT code 7025F is used when the patient information is entered into a reminder system with a target due date for the next mammogram.
Long description: Patient information entered into a reminder system with a target due date for the next mammogram.
Short description: Patient info entered into mammogram reminder system.
4. HCPCS Codes for Screening Mammograms
The following two HCPCS codes are relevant Screening Mammograms.
4.1 HCPCS Code G9899
Lay-term: HCPCS code G9899 is used when the results of a screening, diagnostic, film, digital or digital breast tomosynthesis (3D) mammography are documented and reviewed.
Long description: Screening, diagnostic, film, digital or digital breast tomosynthesis (3D) mammography results documented and reviewed.
Short description: 3D mammography results reviewed.
4.2 HCPCS Code G9900
Lay-term: HCPCS code G9900 is used when the results of a screening, diagnostic, film, digital or digital breast tomosynthesis (3D) mammography were not documented and reviewed.
Long description: Screening, diagnostic, film, digital or digital breast tomosynthesis (3D) mammography results were not documented and reviewed.
Short description: 3D mammography results not reviewed.
