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How to code an Molecular Breast Imaging

Tanya Posted Tue 12th of February, 2013 16:35:16 PM

We were givien 4 procedure codes: 77053: Single Duct Rad Inter, 77054: Multi Duct Rad Inter. 78800: Limited area molecular breast imaging, 78801 Multiple molecular breast imaging.

Do you use both procedure codes in conjuction with eachother?

SuperCoder Answered Wed 13th of February, 2013 23:06:51 PM

Just as imaging of the chest for other nuclear medicine procedures is considered one single limited area, both breasts are considered a single limited area as well. Code 78800, Radiopharmaceutical localization of tumor or distribution of radiopharmaceutical agent(s); limited area,should be reported for a breast scintigraphy study of either one or both breasts. Although it is recognized that there is more work in imaging both breasts, the original intent of the multiple areas code (78801) refers to multiple sites in the body vs both sides of the same part of the body.

According to Correct Coding Initiative edits, there are no bundling issues in 78800/77053 and 78801/77054 of the examples provided. Therefore, your practice may bill both. Nor do these pairs of codes for scans need a modifier since they are considered separate examinations.

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