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76376 for digital breast tomography

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certifiedcoder621

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Red Hook, NY
Does anyone have experience billing this code for digital breast tomography? How are other experienced radiology facilities getting reimbursed for this procedure? BCBS says it is experimental / investigational ,yet Medicare is paying as long as the medical necessity is met... Any feedback is appreciated.
 
If you are talking about digital breast tomosynthesis, ACR says 76376/76377 is not appropriate. Unlisted code 76499 should be coded along with the appropriate G code for digial mammography and the appropriate CAD code (if used). (see ACR Coding Source, May/June 2011.
 
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