Radiology Coding Alert

Question: Is a Miraluma breast scan an ultrasound breast procedure? Our radiology department documented this procedure for a patient with a breast mass. Idaho Subscriber Answer: Miraluma is the brand name for the nuclear medicine breast imaging exam (also called scinti-mammography) that radiologists use to investigate breast abnormalities. You should report S8080 (Scintimam-mography [radioimmunoscintigraphy of the breast], unilateral, including supply of radiopharmaceutical) to payers that recognize this HCPCS Level II code for this procedure. Depending on payer guidelines, you may have to report 78800 (Radiopharmaceutical localization of tumor or distribution of radiopharmaceutical agent[s]; limited area) to describe scintimammograpy.

During this exam, the radiologist injects a radioactive tracer into the patient and evaluates the breast using planar or single positron emission computed tomography (SPECT) radionuclide imaging. Because the dye accumulates differently in cancerous and non-cancerous tissues, scintimammography helps physicians determine whether patients suffer from cancer.

Most Medicare carriers consider scintimammography investigational and either do not cover it, or cover it on a case-by-case basis only.