Nuclear medicine J863 - Scintimammography - unilateral or bilateral

General Info

Billing Amount: $99.95

Description

Scintimammography is not eligible for payment unless at least one of the following conditions is met: a. the patient has a dense breast(s) and one or both of the following risk factors: i. a first degree relative with breast cancer diagnosed prior to age 50; or ii. a first degree relative with breast cancer diagnosed over age 50 and patient is within 5 years of the age when the relative was diagnosed with breast cancer. b. architectural distortion of the breasts due to prior breast surgery, radiotherapy, chemotherapy or the presence of breast prosthesis rendering mammography interpretation difficult; c. malignant breast lesion when mammography is unable to exclude multifocal disease; or d. solitary lesion identified on mammography of greater than 1 cm.

Notes:

For the purpose of this provision, "dense breast(s)" means (a) breast(s) occupied by over 75% fibroglandular tissue as noted on mammography.

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